Barkovich评分、NICHD NRN评分和Weeke评分在新生儿轻度缺氧缺血性脑病的应用

Application of Barkovich score,NICHD NRN score and Weeke score in evaluating the neonates with mild hypoxic-ischemic encephalopathy

目的探讨Barkovich评分、美国国家儿童健康和人类发展研究所(NICHD)新生儿研究网络(NRN)评分和Weeke评分在新生儿轻度缺氧缺血性脑病(HIE)评估中的应用。方法79例HIE患儿在出生后5~7d进行脑部MRI检查,并评估Barkovich评分、NICHD NRN评分和Weeke评分,分析其诊断效能。结果79例患儿中,轻度HIE 38例,中度HIE 25例,重度HIE 16例。轻度HIE组Barkovich评分、NICHD NRN评分和Weeke评分低于中/重度HIE组(P<0.05)。Barkovich评分和NICHD NRN评分诊断HIE的kappa值为0.772。NICHD NRN评分和Weeke评分诊断HIE的kappa值为0.861。Weeke评分和Barkovich评分诊断HIE的kappa值为0.923。Barkovich评分诊断轻度HIE的灵敏度为5.3%,特异度为97.5%,阳性预测值为66.7%,阴性预测值为52.6%,准确度为7.8%。NICHD NRN评分诊断轻度HIE的灵敏度为31.6%,特异度为95.1%,阳性预测值为85.7%,阴性预测值为60.0%,准确度为36.8%。Weeke评分诊断轻度HIE的灵敏度为50.0%,特异度为95.1%,阳性预测值为90.4%,阴性预测值为67.2%,准确度为55.2%。结论Barkovich评分、NICHD NRN评分和Weeke评分均可用于诊断轻度HIE。

Objective To investigate the application of Barkovich score,national institute of child health and human development(NICHD)neonatal research network(NRN)score and Weeke score in the evaluation of the neonates with mild hypoxic-ischemic encephalopathy(HIE).Methods Brain MRI examination was performed in 79children with HIE on 5-7days after birth.Barkovich score,NICHD NRN score and Weeke score of the children were evaluated and their diagnostic efficiency was analyzed.Results Of 79children,38cases had mild HIE,25cases had moderate HIE and 16cases had severe HIE.Barkovich score,NICHD NRN score and Weeke score were lower in the children with mild HIE than those in the children with moderate and severe HIE(P<0.05).The kappavalue of Barkovich score and NICHD NRN score in diagnosing HIE was 0.772.The kappa value of NICHD NRN score and Weeke score in diagnosing HIE was 0.861.The kappavalue of Weeke score and Barkovich score in diagnosing HIE was 0.923.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Barkovich score in diagnosing mild HIE were 5.3%,97.5%,66.7%,52.6%and 7.8%,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of NICHD NRN score in diagnosing mild HIE were 31.6%,95.1%,85.7%,60.0%and 36.8%,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Weeke score in diagnosing mild HIE were 50.0%,95.1%,90.4%,67.2%and 55.2%,respectively.Conclusion Barkovich score,NICHD NRN score and Weeke score can be used for the diagnosis of mild HIE.