摘要
目的探讨振幅整合脑电图(aEEG)评分联合血清脑红蛋白对晚期早产儿脑损伤情况诊断价值。方法回顾性分析2018年1月至2019年12月在邢台市第三医院接受治疗的晚期早产儿133例临床资料。收集患儿aEEG、血清脑红蛋白及早期新生儿神经学评分新生儿20项行为神经测定(NBNA)检测结果。依据判断结果将患者分为脑损伤组(n=45)与无脑损伤组(n=88),比较2组患儿aEEG评分、血清脑红蛋白、NBNA评分,并对aEEG评分、血清脑红蛋白与NBNA评分进行相关性分析。以ROC法判断aEEG评分联合血清脑红蛋白对晚期早产儿脑损伤的诊断价值。结果2组患儿胎龄、性别、分娩方式及出生体质量比较差异无统计学意义(P>0.05)。脑损伤组患儿aEEG评分(7.68±2.04 vs 9.92±3.11)、NBNA评分(33.05±7.14 vs 37.29±2.19)均显著低于无脑损伤组(P<0.01),血清脑红蛋白显著高于无脑损伤组[(158.28±42.09)mg/L vs(119.36±31.84)mg/L,P<0.01]。相关性分析结果显示,aEEG评分与NBNA评分呈显著正相关(r=0.639,P<0.05),血血清脑红蛋白与NBNA评分呈显著负相关关系(r=-0.698,P<0.05)。ROC分析结果显示,aEEG评分对晚期早产儿脑损伤早期诊断cut-off值为10分,AUC为0.893,95%CI为0.830~0.955,敏感度为77.78%,特异性为80.68%;血清脑红蛋白cut-off值为129.71 mg/L,AUC为0.815,95%CI为0.704~0.885,敏感度为73.33%,特异性为84.09%;联合诊断可有效提高诊断敏感度(P<0.05)。结论晚期早产儿脑损伤可引起aEEG评分及血清脑红蛋白改变,aEEG评分及血清脑红蛋白均可用于晚期早产儿脑损伤的诊断且联合诊断可提高诊断敏感性。
Objective To investigate the diagnostic value of amplitude-integrated electroencephalography(aEEG)score combined with serum brain hemoglobin for brain injury in late preterm infants.Methods A retrospective analysis of 133 cases with late preterm infants treated in our hospital from January 2018 to December 2019 was performed.The aEEG,serum brain hemoglobin and early neonatal neurological score of 20 items of newborn behavioral neurological assessment(Nennetal Behavioral Neurological Assessment,NBNA)test results were collected.According to the judgment results,the patients were divided into brain injury group and non-brain injury group.The aEEG score,serum brain hemoglobin and NBNA score of the two groups were compared.The correlation analysis of aEE G score,serum brain hemoglobin and NBNA score was performed.The ROC method was used to judge the diagnostic value of aEEG score combined with serum brain hemoglobin for brain injury in late preterm infants.Results There was no significant difference in gestational age,gender,delivery method and birth weight between the two groups(P>0.05).The aEEG score(7.68±2.04 vs 9.92±3.11)and NBNA score(33.05±7.14 vs 37.29±2.19)in the brain injury group were significantly lower than those in the brain injury-free group(P<0.01).Serum cerebral hemoglobin was significantly higher than the group without brain injury[(158.28±42.09)mg/L vs(119.36±31.84)mg/L,P<0.01].Correlation analysis results showed that aEEG score was significantly positively correlated with NBNA score(r=0.639,P<0.05).Serum hemoglobin was significantly negatively correlated with NBNA score(r=-0.698,P<0.05).ROC analysis results showed that the aEEG score was 10 points for early diagnosis of advanced preterm infants with brain injury(AUC was 0.893,95%CI was 0.830-0.955,sensitivity was 77.78%,specificity was 80.68%).The cut-off value of serum cerebral hemoglobin was 129.71 mg/L(AUC was 0.815,95%CI was 0.704-0.885,sensitivity was 73.33%,specificity was 84.09%).Combined diagnosis can effectively improve the diagnostic sensitivity(P<0.05).Conclusion Brain injury in advanced preterm infants can cause changes in aEEG score and serum brain hemoglobin.Both aEEG score and serum brain hemoglobin can be used for the diagnosis of brain injury in late preterm infants and combined diagnosis can improve the sensitivity of diagnosis.
作者
冀京雷
李秀丽
范雪爱
JI Jing-lei;LI Xiu-li;FAN Xue-ai(Department of Neonatology,Xingtai Third Hospital,Xingtai 054000,Hebei,China)
出处
《东南国防医药》
2021年第2期141-145,共5页
Military Medical Journal of Southeast China
基金
河北省邢台市科技计划项目(2019ZC146)。
关键词
振幅整合脑电图评分
血清脑红蛋白
晚期早产儿
脑损伤
amplitude-integrated electroencephalography(aEEG)score
serum brain hemoglobin
late preterm infants
brain injury