NLR、RDW水平联合振幅整合脑电图在缺氧缺血性脑病患儿的预后研究  

Prognostic evaluation value of NLR and RDW combined with amplitude integrated electroencephalogram in children with hypoxic ischemic encephalopathy

作　　者：梁玉兰[1] 陈亮[1] 曾令梅[1] Liang Yulan;Chen Liang;Zeng Lingmei(Department of Neonatology,Luzhou People's Hospital,Luzhou 646000,China)

机构地区：[1]泸州市人民医院新生儿科,四川泸州646000

出　　处：《中华脑科疾病与康复杂志（电子版）》2023年第2期84-89,共6页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：四川省卫生和计划生育委员会科研课题(16PJ170)。

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、红细胞分布宽度(RDW)联合振幅整合脑电图(aEEG)评分对缺氧缺血性脑病(HIE)新生儿预后的预测价值。方法回顾性分析2017年10月至2019年10月泸州市人民医院新生儿重症监护室收治的76例HIE新生儿的临床资料(HIE新生儿组),另选取78例同期出生的健康新生儿为对照组。比较2组新生儿的NLR、RDW及aEEG评分。绘制受试者工作特征曲线分析NLR、RDW及aEEG评分预测HIE新生儿预后的价值。结果与对照组比较,不同病情程度HIE组NLR、RDW均升高,差异具有统计学意义(P<0.05);中度和重度HIE组的NLR、RDW高于轻度HEI组,重度HIE组高于中度HIE组,且aEEG异常评分随着HIE病情程度升高而依次降低,差异具有统计学意义(P<0.05)。死亡组的NLR、RDW均高于存活组,且aEEG评分低于存活组,差异具有统计学意义(P<0.05)。NLR、RDW、aEEG联合预测HIE新生儿预后的曲线下面积为0.889(95%CI:0.803~0.964),最佳截断值为0.784,敏感度为84.54%,特异度为90.43%,均高于单独指标的敏感度和特异度。结论NLR、RDW水平联合aEEG评分有助于临床评估新生儿HIE预后情况。Objective To explore the prognostic value of neutrophil to lymphocyte ratio(NLR),red blood cell distribution width(RDW)combined with amplitude integrated electroencephalogram(aEEG)score in neonatal hypoxic ischemic encephalopathy(HIE).Methods A retrospective analysis was conducted on the clinical data of 76 HIE newborns admitted to the neonatal intensive care unit of Luzhou People's Hospital from October 2017 to October 2019(HIE neonatal group),and 78 healthy newborns born in the same period were selected as the control group.The NLR,RDW and aEEG scores of the two groups of newborns were compared.The value of drawing receiver operating characteristic curve curves to analyze NLR,RDW levels,and aEEG scores in predicting the prognosis of HIE newborns.Results Compared with the control group,the levels of NLR and RDW in HIE groups with different degrees of illness increased(P<0.05);The levels of NLR and RDW in the moderate and severe HIE groups were higher than those in the mild HEI group,while those in the severe HIE group were higher than those in the moderate HIE group(P<0.05).The aEEG abnormal score decreased sequentially with the severity of HIE(P<0.05).The NLR and RDW levels in the death group were higher than those in the survival group,and the aEEG score was lower than that in the survival group(P<0.05).The AUC of NLR,RDW,and aEEG in predicting the prognosis of HIE newborns is 0.889(95%CI:0.803-0.964),the optimal cutoff value is 0.784,the sensitivity is 84.54%,and the specificity is 90.43%,all of which are higher than the sensitivity and specificity of individual indicators.Conclusion The combination of NLR and RDW levels with aEEG score is helpful in clinical evaluation of the prognosis of neonatal HIE,and is worthy of clinical promotion.

关 键 词：缺氧缺血性脑病 新生儿 中性粒细胞与淋巴细胞比值 红细胞分布宽度 振幅整合脑电图 

分 类 号：R722.1[医药卫生—儿科]