脑干听觉诱发电位联合头颅超声对早产儿颅脑损伤的诊断价值

Value of brainstem auditory evoked potentials combined with cranial ultrasound for diagnosing premature infants with craniocerebral injury

目的:探讨脑干听觉诱发电位(brainstem auditory evoked potential,BAEP)联合头颅超声对早产儿颅脑损伤(premature infants with craniocerebral injury,PICI)的诊断价值,以期为PICI的早期诊断提供参考。方法:选取某院2018年3月至2020年3月新生儿科收治的190例因早产需要住院的患儿作为研究对象,对所有患儿行头颅超声检查、BAEP检查以及BAEP联合头颅超声检查,对比3种诊断方法的检出率,分析BAEP联合头颅超声检查对患儿预后情况的评价,建立Logistic回归方程并绘制ROC曲线,综合评价3种诊断方法对PICI的诊断价值。数据采用SPSS 20.0软件进行统计学分析。结果:头颅超声检查的检出率为53.16%,BAEP检查的检出率为56.84%,BAEP联合头颅超声检查的检出率为65.26%,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,头颅超声检查的优势比(odds ratio,OR)为19.123、95%置信区间为4.876~74.990,BAEP检查的OR为29.724、95%置信区间为10.608~83.284,差异具有统计学意义(P<0.01),PICI检出率的最终预测模型为P=1/(1+e^(1.904+2.951×头颅超声检查+3.392×BAEP检查))。头颅超声检查和BAEP检查的AUC分别为0.829和0.888,BAEP联合头颅超声检查的AUC为0.932,差异具有统计学意义(P<0.05)。结论:BAEP联合头颅超声检查对PICI诊断的检出率高于单一诊断方法,可准确反映患儿的脑功能损伤情况,具有较高的临床价值。

Objective To investigate the value of brainstem auditory evoked potential(BAEP)combined with cranial ultrasound in the diagnosis of premature infants with craniocerebral injury(PICI)to facilitate the early diagnosis of PICI.Methods A total of 190 premature infants admitted to the neonatology department of some hospital from March 2018 to March 2020 were selected as the study subjects,who were examined with cranial ultrasound,BAEP and combined BAEP and cranial ultrasound.The detection rates of the three diagnostic methods were compared,and the relationship between the results of BAEP combined with cranial ultrasound and the prognosis of the infants was explored.Logistic regression equations were established and ROC curves were produced to comprehensively evaluate the diagnostic values of the three diagnostic methods for PICI.The data were statistically analyzed using SPSS 20.0 software.Results The detection rate was 53.16%by cranial ultrasound,56.84%by BAEP and 65.26%by BAEP combined with cranial ultrasound,with statistically significant differences(P<0.05).Logistic regression analysis showed that the odds ratio(OR)for cranial ultrasound was 19.123,with a 95%confidence interval from 4.876 to 74.990 and the OR for BAEP examination was 29.724 with a 95%confidence interval from 10.608 to 83.284,with a statistically significant difference(P<0.01).The final prediction model for PICI detection rate was P=1/(1+^(e1.904+2.951×cranial ultrasound+3.392×BAEP)).The AUCs were 0.829 and 0.888 for cranial ultrasound and BAEP,respectively,and 0.932 for BAEP combined with cranial ultrasound,with a statistically significant difference(P<0.05).Conclusion BAEP combined with cranial ultrasound has a higher detection rate than any single diagnostic method for PICI,which can accurately reflect the functional brain damage of the child,and thus is worthy promoting clinically.[Chinese Medical Equipment Journal,2021,42(12):64-67]