BIND评分、B/A及AABR对新生儿急性胆红素脑病预后不良的早期预测价值  

The Early Predictive Value of BIND Score, B/A and AABR on the PoorPrognosis of Neonatal Acute Bilirubin Encephalopathy

作　　者：张瑞丽 徐发林[1] 李文华 ZHANG Ruili;XU Falin;LI Wenhua(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院新生儿科,河南郑州450052

出　　处：《河南医学研究》2021年第18期3308-3311,共4页Henan Medical Research

摘　　要：目的探讨胆红素诱导的神经功能障碍(BIND)评分、血清总胆红素与白蛋白比值(B/A)及自动听觉脑干诱发电位技术(AABR)对新生儿急性胆红素脑病发生不良预后的早期预测价值。方法对郑州大学第三附属医院新生儿重症监护室病房收治的120例胎龄≥35周的急性胆红素脑病患儿进行前瞻性研究,收集患儿临床资料并随访至12个月月龄,根据预后情况分为预后正常组和预后不良组,比较两组患儿的临床资料,采用受试者工作(ROC)曲线分析BIND评分、B/A及AABR对新生儿急性胆红素脑病发生不良预后的早期预测价值。结果预后正常组72例,预后不良组37例,失访11(9.2%)例。ROC曲线分析表明BIND评分(≥6分)、B/A(≥8.3)比AABR能够更好地预测急性胆红素脑病不良预后,曲线下面积分别为0.883、0.869、0.753,对应的敏感性分别为73.9%、91.3%、87%,特异性分别为92.7%、78.2%、63.6%,而3项指标联合预测不良预后的效果最好,ROC曲线下面积最大,为0.925,在最佳临界点所对应的敏感性为95.7%。结论 BIND、B/A相较于AABR能够更好地预测新生儿急性胆红素脑病发生不良预后,而三者联合预测效果最好。Objective To explore the early predictive value of bilirubin-induced neurological dysfunction(BIND)score,bilirubin-albumin ratio(B/A)and automatic auditory brainstem response(AABR)on the poor prognosis of neonatal acute bilirubin encephalopathy.Methods One hundred and twenty child patients of acute bilirubin encephalopathy with gestational age≥35 weeks in neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University were prospectively studied.The clinical data were collected and followed up to 12 months.According to the outcomes,they were divided into normal outcomes group and poor outcomes group.The clinical data of the two groups were compared,and the BIND score,B/A and AABR were analyzed by receiver operating characteristic(ROC)curve.Results There were 72 cases with normal outcomes and 37 cases with poor outcomes,and 11 cases lost to follow-up.ROC curve analysis showed that BIND score(≥6 points)and B/A(≥8.3)were better than AABR in predicting the adverse outcomes of acute bilirubin encephalopathy.The area under the curve was 0.883,0.869 and 0.753 respectively.The corresponding sensitivity were 73.9%,91.3%,87%,and specificity were 92.7%,78.2%,63.6%,respectively.The combination of the three indicators had the best effect in predicting adverse outcomes,and the area under the ROC curve was the largest,which was 0.925.The sensitivity at the best critical point was 95.7%.Conclusion BIND and B/A are better than AABR in predicting the adverse prognosis of neonatal acute bilirubin encephalopathy,and the combination of them is the best.

关 键 词：新生儿 急性胆红素脑病 预后 胆红素诱导的神经功能障碍评分 

分 类 号：R722[医药卫生—儿科]