双指标法筛查新生儿先心病最佳时间段分析

Analysis of the best time period for screening congenital heart disease in neonates by double index method

目的探讨通过双指标法筛查新生儿先心病的最佳筛查时机。方法选择2022年2月~2023年1月于潍坊医学院附属医院及潍坊市人民医院出生的新生儿13301例为研究对象,随机分为3组(~24h组,~48h组,~72h组);用双指标法筛查先心病,对筛查阳性者行心脏彩超以确诊;对比各组灵敏度、特异度、假阳性率,选出最佳筛查时机。结果~24h组筛查灵敏度为55.56%,特异度为98.86%,假阴性率为44.44%,假阳性率为1.13%,约登指数为0.54,一致率为98.69%,κ值为0.252;~48h组的筛查灵敏度为69.57%,特异度为99.21%,假阴性率为30.43%,假阳性率为0.79%,约登指数为0.69,一致率为99.05%,κ值为0.456;~72h组的筛查灵敏度为74.07%,特异度为99.59%,假阴性率为25.93%,假阳性率为0.41%,约登指数为0.74,一致率为99.44%,κ值为0.613。结论生后48~72h筛查灵敏度和特异度最高,假阴性率和假阳性率最低,一致率和κ值最大,筛查时间最佳,具有一定的临床价值。

Objective To screen congenital heart disease in newborns by double index method and explore the best screening time.Methods From February 2022 to January 2023,a total of 13,301 neonates born in the obstetrics department of the Affiliated Hospital of Weifang Medical University and Weifang People's Hospital were selected as the research objects,which were randomly divided into 24h group,48h group and 72h group.The congenital heart disease was screened by double index method,and the positive patients were diagnosed by color ultrasound.The sensitivity,specificity and false positive rate of each group were compared in order to select the best screening time.Results The sensitivity,specificity,false negative rate,false positive rate,Yoden index,agreement rate andκvalue in 24h group were 55.56%,98.86%,44.44%,1.13%,0.54,98.69%and 0.252 respectively.The sensitivity,specificity,false negative rate,false positive rate,Yoden index,agreement rate andκvalue in 48h group were 69.57%,99.21%,30.43%,0.79%,0.69,99.05%and 0.456 respectively.The sensitivity,specificity,false negative rate,false positive rate,Yoden index,agreement rate andκvalue in 72h group were 74.07%,99.59%,25.93%,0.41%,0.74,99.44%and 0.613 respectively.Conclusion Within 48 to 72 hours of birth,the screening sensitivity and specificity were the highest,the false negative rate and false positive rate were the lowest,the consistency rate andκvalue were the highest,the screening time was the best,which has certain clinical value.