振幅整合脑电图联合脐血血气分析对缺氧缺血性脑病新生儿预后的预测价值  

Value of Amplitude-integrated Electroencephalogram Combined with Cord Blood Gas Analysis in Prediction of Neonatal Hypoxic Ischemic Encephalopathy

作　　者：贺铮 赵燕 杨阳 张桂云 HE Zheng;ZHAO Yan;YANG Yang;ZHANG Gui-yun(Department of Neonatology,Jinxin Women's and Children's Hospital,Chengdu 610000,China)

机构地区：[1]四川锦欣妇女儿童医院新生儿科,成都610000

出　　处：《临床误诊误治》2022年第4期79-82,共4页Clinical Misdiagnosis & Mistherapy

基　　金：四川省医学会科研课题资助项目(S19018)。

摘　　要：目的探究振幅整合脑电图(aEEG)联合脐血血气分析对缺氧缺血性脑病(HIE)新生儿预后的预测价值。方法回顾性分析2019年1月—2020年12月治疗的HIE新生儿61例为研究对象,按照新生儿预后结果分为预后良好组(Gesell发育量表评分>75分)40例和预后不良组(Gesell发育量表评分≤75分)21例。比较两组的aEEG检查结果、脐血血气分析指标差异,应用受试者工作特征(ROC)曲线分析上述指标对HIE新生儿预后的预测价值。结果预后良好组aEEG振幅正常比例高于预后不良组,轻度异常和严重异常占比低于预后不良组(P<0.01);预后良好组脐血血气分析指标pH值、氧分压、碳酸氢根水平均高于预后不良组(P<0.05,P<0.01)。aEEG联合脐血血气分析预测HIE新生儿预后的敏感度、特异度分别为85.71%、97.50%,ROC曲线下面积为0.916(95%CI:0.816,0.972)。结论aEEG联合脐血血气分析对HIE新生儿的预后具有一定的临床预测价值,可为临床治疗提供参考。Objective To explore the value of amplitude-integrated electroencephalogram(aEEG)combined with cord blood gas analysis in prediction of neonatal hypoxic ischemic encephalopathy(HIE).Methods A total of 61 neonates with HIE treated between January 2019 and December 2020 were enrolled for retrospective analysis.According to the neonatal prognoses,they were divided into good prognosis group(Gesell development scale score more than 75,n=40)and poor prognosis group(Gesell development scale score less than or equal to 75,n=21).Differences of aEEG examination results and cord blood gas analysis indexes were compared between two groups,and values of the above indicators in prediction of prognoses of HIE neonates were analyzed by receiver operating characteristic(ROC)curve.Results In good prognosis group,proportion of normal aEEG amplitude was significantly higher,while proportions of mild and severe abnormalities were significantly lower than those in poor prognosis group(P<0.01).The pH value,partial pressure of oxygen and bicarbonate level of cord blood in good prognosis group were significantly higher than those in poor prognosis group(P<0.05,P<0.01).The sensitivity and specificity of aEEG combined with cord blood gas analysis in prediction of the prognoses of neonatal HIE were 85.71% and 97.50% respectively,and the area under the ROC curve(AUC)was 0.916(95%CI:0.816,0.972).Conclusion The aEEG combined with cord blood gas analysis has a certain clinical value in prediction of neonatal HIE,which may provide a reference for clinical treatment.

关 键 词：缺氧缺血性脑病 新生儿 振幅脑电图 脐血 血气分析 预后 

分 类 号：R743[医药卫生—神经病学与精神病学] R722.1[医药卫生—临床医学]