全身运动评估联合头颅MRI对重度黄疸患儿运动发育结局的预测价值  

Predictive value of general movement assessment combined with cranial MRI on motor development outcomes in infants with severe jaundice

作　　者：史廷娇 谭宁 吴州丽[1] 谢月娥[1] 谭若锟[1] SHI Ting-jiao;TAN Ning;WU Zhou-li;XIE Yue-e;TAN Ruo-kun(Department of Neonatology,the First Peopled Hospital of Chenzhou,Cheruhou 423000,Hunan,China;The Fifth Affiliated Hospital Sun Yet-sen University,Zhuhai 519000,Guangdong,China)

机构地区：[1]湖南省郴州市第一人民医院新生儿科,湖南省郴州市423000 [2]中山大学附属第五医院,广东省珠海市519000

出　　处：《广西医学》2022年第19期2207-2211,共5页Guangxi Medical Journal

基　　金：湖南省卫生计生委科研计划课题项目(B20180259);湖南省郴州市技术创新引导项目(lcyl2021082);湘南学院校级科学研究项目(2021XJ143)。

摘　　要：目的分析全身运动评估联合头颅MRI对重度黄疸患儿运动发育结局的预测价值。方法选取183例重度黄疸患儿,分析其纠正胎龄37~48周时的全身运动评估和头颅MRI检查结果。收集出院后随访1年时的运动发育情况。分析全身运动评估联合头颅MRI对重度黄疸患儿运动发育结局的预测价值。结果(1)183例重度黄疸患儿中,随访1年时的运动发育评估异常为48例,包括30例运动发育迟缓、18例脑瘫。(2)预测重度黄疸患儿运动发育结局异常时,全身运动评估、头颅MRI、两者联合的灵敏度分别为97.9%、70.8%、68.8%,特异度分别为27.4%、96.3%、99.3%,阳性预测值分别为32.4%、87.2%、97.1%,阴性预测值分别为97.4%、90.3%、89.9%。联合检查的特异度和阳性预测值均优于单纯全身运动评估(均P<0.05)。(3)预测重度黄疸患儿发生脑瘫时,痉挛同步性全身运动、头颅MRI、两者联合的灵敏度分别为72.2%、100.0%、72.2%,特异度分别为92.7%、87.3%、99.4%,阳性预测值分别为52.0%、46.2%、92.9%,阴性预测值分别为96.8%、100.0%、97.0%。联合检查的特异度和阳性预测值均优于单纯全身运动评估或头颅MRI(均P<0.05)。结论全身运动评估联合头颅MRI预测重度黄疸患儿运动发育结局有较好的互补作用,有一定的临床预测价值。Objective To analyze the predictive value of general movement assessment combined with cranial MRI on motor development outcomes in infants with severe jaundice.Methods A total of 183 infants with severe jaundice were selected,and the general movement assessment and cranial MRI examination results of the infants with correct gestational age of 37-48 weeks were analyzed.The motor development of 1-year follow-up after discharge was collected.The predictive value of general movement assessment combined with cranial MRI on motor development outcomes in infants with severe jaundice was analyzed.Results(1)Among 183 infants with severe jaundice,48 cases were assessed as abnormal assessment of motor development at 1 year follow-up,including 30 cases of motor retardation and 18 cases of cerebral palsy.(2)When the motor development outcomes were predicted as abnormal in infants with severe jaundice,the sensitivities of the general movement assessment,cranial MRI,and combination of the two were 97.9%,70.8%,and 68.8%,respectively;the specificities were 27.4%,96.3%,and 99.3%,respectively;the positive predictive values were 32.4%,87.2%,and 97.1%,respectively;the negative predictive values were 97.4%,90.3%,89.9%,respectively.The specificity and positive predictive value of combination detection were all superior to those of general movement assessment alone(all P<0.05).(3)When cerebral palsy were predicted in infants with severe jaundice,the sensitivities of spastic synchrony of general movement,cranial MRI,and combination of the two was 72.2%,100.0%,and 72.2%,respectively;the specificities were 92.7%,87.3%,and 99.4%,respectively;the positive predictive values were 52.0%,46.2%,92.9%,respectively;the negative predictive values were 96.8%,100.0%,and 97.0%,respectively.The specificity and positive predictive value of combination detection were all superior to those of general movement assessment or cranial MRI alone(all P<0.05).Conclusion The general movement assessment combined with cranial MRI in predicting motor development out

关 键 词：重度黄疸 运动发育结局 全身运动评估 磁共振 预测价值 

分 类 号：R722.17[医药卫生—儿科]