基于高胆红素血症新生儿苍白球/壳核T_(1)WI信号强度比值模型构建及其对胆红素脑病的预测价值  

Construction of Hyperbilirubinemia Neonatal Model Based on Globus Pallidus/Putamen T_(1)WI Signal Intensity Ratio and Its Predictive Value for Bilirubin Encephalopathy

作　　者：汤文建 黄裕斌 李莉 钟俭平 TANG Wen-jian;HUANG Yu-Bin;LI Li;ZHONG Jian-ping(Department of Medical Imaging,Ganzhou People's Hospital,Ganzhou Hospital Affiliated to Nanchang University,Ganzhou 341000,Jiangxi Province,China;Department of Rehabilitation Medicine,Ganzhou People's Hospital,Ganzhou Hospital Affiliated to Nanchang University,Ganzhou 341000,Jiangxi Province,China;Department of Pediatrics,Ganzhou People's Hospital,Ganzhou Hospital Affiliated to Nanchang University,Ganzhou 341000,Jiangxi Province,China)

机构地区：[1]赣州市人民医院(南昌大学附属赣州医院)医学影像科,江西赣州341000 [2]赣州市人民医院(南昌大学附属赣州医院)康复医学科,江西赣州341000 [3]赣州市人民医院(南昌大学附属赣州医院)儿科,江西赣州341000

出　　处：《中国CT和MRI杂志》2024年第4期23-25,共3页Chinese Journal of CT and MRI

基　　金：国家自然科学基金项目(82160330);江西省自然科学基金项目(20202ACBL216006);赣州市科技计划项目(2022-ZD1373);赣州市卫生健康委员会市级科研计划项目(GZWJW202402120)。

摘　　要：目的探究高胆红素血症(HB)新生儿的苍白球/壳核(G/P)T_(1)WI信号强度比值的影响因素并构建模型预测急性胆红素脑病(ABE)的发生风险。方法回顾性分析2017年7月-2022年12月在我院接受颅脑MR检查的HB新生儿140例及ABE新生儿3例。收集两组临床资料包括性别、年龄、胎龄、出生体重、血清总胆红素(TB)、血清总胆红素/白蛋白(B/A)、是否具有感染或败血症、是否具有ABO溶血、是否具有葡萄糖-6-磷酸脱氢酶(G6PD)缺乏及是否具有酸中毒。构建Logistic回归模型筛选出HB新生儿G/P比值的影响因素,并探究基于HB新生儿G/P比值的多重回归方程能否预测ABE的发生风险。结果年龄OR=0.747(95%CI 0.674-0.828),胎龄OR=0.942(95%CI 0.905-0.981)及血清总胆红素OR=1.004(95%CI 1.000-1.008)是HB新生儿G/P比值的影响因素,基于HB新生儿的多重线性回归方程为Y(预测G/P)=2.945-0.018×X_(1)(年龄)-0.004×X_(2)(胎龄)+0.0003×X_(3)(血清总胆红素)。G/P比值的实测值较预测值升高8%以上时,需要警惕ABE发生风险。结论年龄、胎龄及血清总胆红素是HB新生儿G/P比值的影响因素,基于HB新生儿的G/P构建的多重线性回归模型能预测ABE发生风险。Objective To explore the factors influencing the globus pallidus/putamen(G/P)T_(1)WI signal intensity ratio in neonates with hyperbilirubinemia(HB)and to build a model for predicting the risk of acute bilirubin encephalopathy(ABE).Methods A retrospective analysis was performed on 140 cases of HB neonates and 3 cases of ABE neonates who received cranial MR examination in our hospital from July 2017 to December 2022.Clinical data were collected for both groups including sex,age,gestational age,birth weight,Serum total bilirubin(TB),serum total bilirubin/albumin(B/A)ratio,the presence or absence of neonatal infection or sepsis,ABO hemolysis,glucose-6-phosphate dehydrogenase(G6PD)deficiency,and acidosis.A Logistic regression model was constructed to screen out the influencing factors of G/P ratio in HB neonatal,and to explore whether multiple regression equation based on G/P ratio of HB neonatal could predict the risk of BE.Results Age[OR=0.747(95%CI 0.674-0.828)],gestational age[OR=0.942(95%CI 0.905-0.981)]and serum total bilirubin[OR=1.004(95%CI 1.000-1.008)]were the influencing factors of G/P ratio in HB neonatal.The multiple linear regression equation was of HB neonatal was Y(predicted G/P)=2.945-0.018×X_(1)(age)-0.004×X_(2)(gestational age)+0.0003×X_(3)(total serum bilirubin).When measurement value of G/P ratio is 8%higher than that of predicted value,attention should be paid to the risk of ABE.Conclusion Age,gestational age and serum total bilirubin are the factors influencing the G/P ratio of HB neonates,and the multiple linear regression model based on the G/P ratio of HB neonates can predict the risk of ABE.

关 键 词：高胆红素血症 急性胆红素脑病 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]