振幅整合脑电图联合全身运动扭动阶段评估在新生儿重度胆红素血症发育结局的预测价值

Predictive values of general movements qulity assessment and amplitude-integrated electroencephligram in motor development outcomes of neonates with severe hyperbilirubinemia

目的探讨振幅整合脑电图(aEEG)联合全身运动质量(GMs)扭动阶段评估在新生儿重度高胆红素血症患儿12月龄时发育结局的早期预测价值。方法回顾性分析2020年1月至2022年6月内蒙古医科大学附属医院NICU收治的125例新生儿重度高胆红素血症的临床资料。所有患儿均在入院24 h内监测aEEG;在住院期间,患儿胆红素值降至光疗干预值以下,生命体征平稳,进行GMs评估;12月龄时采用Griffiths发育评估量表对发育结果进行评估。结果共纳入125例患儿,其中男82例(65.6%),女73例(58.4%),平均胎龄(38.1±1.5)周,平均出生体重(3169±573)g,平均血清胆红素(378.5±51.9)μmol/L。12月龄时Griffiths发育评估结果:发育异常39例(31.2%),正常86例(68.8%)。GMs扭动阶段评估预测重度高胆红素血症患儿发育结局的敏感度和阴性预测值均为100%,特异度为19.77%。aEEG在预测重度高胆红素血症患儿的发育结局时,敏感度为92.31%,阴性预测值为94.92%,特异度较高,为65.12%。aEEG+GMs评估预测重度高胆红素血症患儿发育结局的敏感度和阴性预测值分别为87.18%、92.42%,特异度最高为70.93%。结论GMs扭动阶段评估,aEEG评估、aEEG联合GMs早期评估对重度高胆红素血症患儿发育结局均有较好的预测价值。aEEG联合GMs评估有较高的特异度,可提高高胆红素血症患儿发育结局的预测效果。

ObjectiveTo explore the early predictive value of amplitude-integrated electroencephalogram(aEEG)combined with general movements(GMs)assessment for motor development outcomes in infants with severe hyperbilirubinemia at 12 months of age.MethodsThe clinical data of 125 cases of neonates with severe hyperbilirubinaemia admitted to the NICU at Inner Mongolia Medical University Hospital from January 2020 to June 2022 were retrospectively analyzed.The aEEG were performed within 24 h of admission;GMs assessment were carried out at the duration of hospital stay,when the serum bilirubin values decreased below phototherapy intervention value and the infant was stable.The patients were regularly followed-up until one-year-old to evaluate the predictive values by Griffiths Developmental Scale.ResultsA total of 125 infants with severe hyperbilirubinemia were enrolled,including 82(65.6%)males and 73(58.4%)females,with the mean gestational age of(38.1±1.5)weeks,the mean birth weight of(3169±573)g,and the mean serum bilirubin of(378.5±51.9)μmol/L.Of the 125 infants diagnosed by Griffiths assessment at the age of 12 months,normal in 86 cases(68.8%),and abnormal in 39 cases(31.2%).GMs writhing phase assessment had a sensitivity of 100%,negative predictive value of 100%and specificity of 19.77%in predicting motor developmental outcome in neonates with severe hyperbilirubinaemia.The aEEG had a sensitivity of 92.31%and a negative predictive value of 94.92%in predicting motor developmental outcome in neonates with severe hyperbilirubinaemia,with a higher specificity of 65.12%.The sensitivity and negative predictive value of aEEG+GMs assessment for predicting motor developmental outcome in neonates with severe hyperbilirubinaemia were 87.18%and 92.42%,respectively,with the highest specificity of 70.93%.ConclusionGMs writhing stage assessment,aEEG assessment,and aEEG combined with GMs early assessment have good predictive value for motor developmental outcomes in neonates with severe hyperbilirubinaemia.The aEEG combined with GMs assessment has a high specificity,which can improve the predictive effect of motor developmental outcomes in neonates with hyperbilirubinaemia.