振幅整合脑电图联合全身运动和婴儿运动量表在脑瘫高危早产儿运动发育异常中的预测效果  

Amplitude-integrated electroencephalogram combined with general movements scale and Alberta infant motor scale in prediction of motor developmental abnormality in high-risk preterm infants with cerebral palsy

作　　者：张九菊 梁丽霞 袁志忠 刘义粉 李洋 崔彦存 杜桂梅 杜晓宁 孙海英 刘燕 刘金和 Zhang Jiuju;Liang Lixia;Yuan Zhizhong;Liu Yifen;Li Yang;Cui Yancun;Du Guimei;Du Xiaoning;Sun Haiying;Liu Yan;Liu Jinhe(Department of Neonatalogy,Hengshui People’s Hospital,Hengshui 053000,Hebei;Clinical Laboratory,HengshuiFourth People’s Hospital,Hengshui 053000,Hebei;Department of Neonatalogy,Hengshui Maternal and Children’sHospital,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院新生儿科,河北衡水053000 [2]衡水市第四人民医院检验科,河北衡水053000 [3]衡水市桃城区妇幼保健院新生儿科,河北衡水053000

出　　处：《中华生物医学工程杂志》2020年第2期170-175,共6页Chinese Journal of Biomedical Engineering

基　　金：衡水市科技计划项目(2016014104Z)。

摘　　要：目的探讨振幅整合脑电图(aEEG)联合全身运动评估(GMs)、Alberta婴儿运动量表(AIMS)在脑瘫高危早产儿运动发育异常中的预测效果。方法选取2016年8月至2018年8月河北省衡水市人民医院收治的282例脑瘫高危早产儿作为研究对象,依据北京市儿童医院保健所指定的评估量表作为诊断标准(金标准)评估患儿运动发育情况。对于发育正常、脑瘫高危早产儿运动发育异常的患儿,采用Kappa检验分析aEEG、GMs、AIMS、3种方法联合检测(aEEG联合GMs、AIMS诊断同时阳性)与金标准的诊断一致性,采用ROC曲线比较单独检测和联合检测的诊断效能。结果通过对患儿的发育量表评估,运动发育正常患儿100例,可疑异常患儿98例,运动发育异常患儿84例。aEEG、GMs、AIMS、联合检测诊断与金标准的诊断一致性较强(Kappa=8.992,P=0.000;Kappa=9.331,P=0.000;Kappa=8.332,P=0.000;Kappa=9.021,P=0.000),单独采用aEEG、GMs、AIMS以及联合检测灵敏度分别为95.29%、91.25%、92.35%、88.05%,特异度分别为36.47%、35.74%、35.25%、38.60%,曲线下面积分别为0.603(95%CI:0.600~0.746)、0.692(95%CI:0.607~0.816)、0.652(95%CI:0.595~0.799)、0.775(95%CI:0.520~0.872)。联合检测诊断的价值和特异度高于单独检查(均P<0.05)。结论aEEG联合GMs、AIMS在脑瘫高危早产儿运动发育异常中的预测效果较好,建议临床推广。Objective To investigate the value of amplitude integrated electroencephalogram(aEEG)combined with assessment of general movements(GMs)and Alberta infant motor scale(AIMS)in prediction of motor developmental abnormality in high-risk preterm infants with cerebral palsy.Methods Included in this study were 282 high-risk preterm infants with cerebral palsy admitted toHengshui People’s Hospital in Hebei Province between August 2016 and August 2018.The motor development in these children were assessed using the evaluation scale recommended by Beijing Children’s Hospital Healthcare Center as diagnostic criteria(gold standard).For normally developed infants and high-risk preterm infants with cerebral palsy and motor developmental abnormalities,Kappa test was used to determine the diagnostic concordance between combined assessment using aEEG,GMs and AIMS(as defined by triple positivity of the three methods)and the gold standard.Receiver operating characteristics(ROC)curve was used to analyze the diagnostic performance of the three methods used alone and incombination.Results According to gold standard development evaluation,there were 100 infants with normal motor development,98 with suspected,and 84 with confirmed motor developmental abnormalities.aEEG,GMs and AIMS alone or incombination showed strong diagnostic concordance with the gold standard(Kappa=8.992,P=0.000;Kappa=9.331,P=0.000;Kappa=8.332,P=0.000;Kappa=9.021,P=0.000).Using aEEG,GMs and AIMS alone and incombination,the diagnostic sensitivity was 95.29%,91.25%,92.35%and 88.05%,respectively;the specificity were 36.47%,35.74%,35.25%,and 38.60%,respectively.The area under the ROC curve(AUC)were 0.603(95%CI:0.600-0.746),0.692(95%CI:0.607-0.816),0.652(95%CI:0.595-0.799),0.775(95%CI:0.520-0.872)respectively.Combined use of the three methods yielded higher diagnostic value and specificity compared with any method used alone(all P<0.05).Conclusion aEEG combined with GMs and AIMS offers good prediction for motor developmental abnormalities in high-risk preterm infants

关 键 词：振幅整合脑电图 全身运动评估 Alberta婴儿运动量表 脑性瘫痪 运动发育障碍 

分 类 号：R722.6[医药卫生—儿科] R741.044[医药卫生—临床医学]