新生儿行为神经测定评分联合血清胆红素总量/白蛋白比值预测新生儿高胆红素血症并发急性胆红素脑病的临床价值

Clinical study of NBNA score combined with B/A in predicting neonatal hyperbilirubinemia complicated with acute bilirubinine encephalopathy

目的 探讨新生儿行为神经测定(NBNA)评分联合血清胆红素总量/白蛋白比值(B/A)预测新生儿高胆红素血症并发急性胆红素脑病的临床价值。方法 收集2020年5月—2021年6月杭州市妇产科医院收治的患儿62例为观察组,另选取在院进行健康体检的婴儿62例为对照组。检测两组NBNA评分、B/A水平,分析NBNA评分、B/A在高胆红素血症及其并发病情的表达水平以及对高胆红素血症以及并发症状的诊断价值。结果 观察组B/A表达水平高于对照组(8.51±2.03 vs. 5.69±1.35),NBNA评分表达水平低于对照组(26.88±4.23 vs. 35.33±5.61),差异有统计学意义(P<0.05)。logistic回归分析显示,B/A水平表达上升,NBNA评分表达水平下降是患有高胆红素血症以及并发不良病症患儿的重要影响机制。ROC曲线显示,两项联合对患有高胆红素血症及并发不良病症患儿的诊断价值高于NBNA评分、B/A单项诊断[AUC(95%CI):0.944(0.896~0.991)vs.0.823(0.749~0.897)vs.0.782(0.699~0.866)],差异有统计学意义(P<0.05)。结论 对于研究患有不良病症患儿情况变化,可检测出B/A水平表达上升,NBNA评分表达下降,能够有效地提前对患儿病情进行预测,减少不良反应的发生。

Objective To analyze the clinical study of neonatal behavioral nerve determination(NBNA) score combined with serum total bilimbin/albunlin ratio(B/A) to predict neonatal hyperbilirubinemia complicated with acute bilirubinin encephalopathy.Methods A total of 62 children admitted to our hospital from May 2020 to June 2021 were collected as the research group, and 62 infants were selected for physical examination in our hospital as the control group.The NBNA score and B/A levels in the two groups were tested to explore the expression level of NBNA score, B/A expression level in hyperbilirubinemia and its concurrent conditions and the diagnostic value of hyperbilirubinemia and complicated symptoms.Results The expression level of B/A in observation group was higher than that in control group(8.51±2.03 vs.5.69±1.35), and the expression level of NBNA score was lower than that in control group(26.88±4.23 vs.35.33±5.61),the difference is statistically significant(P<0.05). Logistic regression analysis showed that the increased level of B/A and the decreased level of NBNA score were important influencing mechanisms for children with hyperbilirubinemia and complicated adverse symptoms. ROC curve showed that the diagnostic value of the combination of these two factors in children with hyperbilirubinemia and adverse symptoms was higher than that of NBNA score and B/A single diagnosis [AUC(95%CI):0.944(0.896-0.991) vs.0.823(0.749-0.897) vs.0.782(0.699-0.866)],the difference is statistically significant(P<0.05).Conclusion For the study of children with adverse diseases, the expression of B/A level and NBNA score can decrease, which can effectively predict the condition of children in advance and reduce the occurrence of adverse symptoms.