听性脑干反应联合新生儿行为神经评测对新生儿高胆红素血症的诊断意义  

Diagnostic Significance of Auditory Brainstem Response Combined with Neonatal Behavioral Neural Evaluation for Neonatal Hyperbilirubinemia

作　　者：赵永健[1] 梁敏仪 ZHAO Yongjian;LIANG Minyi(Jiangmen Maternity and Child Health Care Hospital,Jiangmen 529000,China;不详)

机构地区：[1]广东省江门市妇幼保健院,广东江门529000

出　　处：《中国医学创新》2021年第12期115-119,共5页Medical Innovation of China

摘　　要：目的:探究听性脑干反应联合新生儿行为神经评测对新生儿高胆红素血症的诊断意义。方法:选择2019年1月-2020年10月于本院接受治疗的230例高胆红素血症新生儿为研究组,另选取同期于本院接受治疗的50例健康新生儿为对照组。分别对两组新生儿开展脑干听觉诱发电位(BAEP)和新生儿行为神经测定(NBNA),比较两组新生儿间的差异,Spearman分析BAEP、NBNA与新生儿总胆红素水平相关性,最后分别绘制BAEP、NBNA及两者联合检测对总胆红素血症诊断ROC曲线。结果:研究组的BAEP异常率及BAEP平均阈值均明显高于对照组,差异均有统计学意义(P<0.05)。研究组新生儿NBNA中的行为能力、被动与主动肌张力、原始反射、一般状态及总分均明显低于对照组,差异均有统计学意义(P<0.05)。Spearman分析结果显示BAEP平均阈值与血清总胆红素水平呈正相关(P<0.05),NBNA总分与血清总胆红素呈负相关(P<0.05)。ROC曲线结果显示,BAEP、NBNA以及两者联合检测对新生儿高胆红素血症的诊断AUC分别为0.934 9、0.873 7、0.974 0(P<0.05)。结论:听性脑干反应与新生儿行为神经评测均能够较好地对新生儿高胆红素血症开展诊断,但联合诊断临床价值更为突出,值得开展临床推广用。Objective:To investigate the diagnostic significance of auditory brainstem response combined with neonatal behavioral neural evaluation for neonatal hyperbilirubinemia.Method:A total of 230 neonates with hyperbilirubinemia treated in our hospital from January 2019 to October 2020 were selected as the study group,and 50 healthy neonates treated in our hospital during the same period were selected as the control group.Brainstem auditory evoked potential(BAEP)and neonatal behavioral neurological assessment(NBNA)were performed respectively in two groups,and the differences between two groups were compared.Spearman analyzed the correlation between BAEP,NBNA and neonatal total bilirubinemia,and finally drew the ROC curves of BAEP,NBNA and the combination of BAEP and NBNA in the diagnosis of total bilirubinemia.Result:The abnormal rate of BAEP and the mean threshold of BAEP in the study group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The behavioral ability,passive and active muscle tone,primary reflex,general state and total score of NBNA in the study group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Spearman analysis showed that the mean threshold of BAEP was positively correlated with serum total bilirubin level(P<0.05),and the total NBNA score was negatively correlated with serum total bilirubin level(P<0.05).ROC curve results showed that the AUC of BAEP,NBNA and the combination of BAEP and NBNA in the diagnosis of neonatal hyperbilirubinemia were 0.9349,0.8737 and 0.9740(P<0.05),respectively.Conclusion:Both auditory brainstem response and neonatal behavioral nerve assessment can better diagnose neonatal hyperbilirubinemia,but the combined diagnosis has more outstanding clinical value and is worthy of clinical promotion.

关 键 词：听性脑干反应 新生儿行为神经评测 高胆红素血症 

分 类 号：R722.17[医药卫生—儿科]