UABGA和NBNA评分预测新生儿HIE短期预后的价值  

Value of UABGA and NBNA score in predicting short-term prognosis of HIE

作　　者：邓茂文 贾鹏 吴虹 DENG Maowen;JIA Peng;WU Hong(Department of Rediatris,Cuiping District Maternal and Child Health Care and Family Planning Service Center of Yibin,Yibin 644002,Sichuan,China;Department of Rediatris,Zigong First People’s Hospital,Zigong 646000,Sichuan,China)

机构地区：[1]宜宾市翠屏区妇幼保健计划生育服务中心儿科,四川宜宾644002 [2]自贡市第一人民医院儿科,四川自贡646000

出　　处：《中南医学科学杂志》2024年第2期254-257,共4页Medical Science Journal of Central South China

基　　金：宜宾市科技基金项目(2021SF02)。

摘　　要：目的探讨脐动脉血气分析(UABGA)和神经行为测定(NBNA)评分对新生儿缺氧缺血性脑病(HIE)短期预后的预测价值。方法随机选取分娩的足月新生儿1877例,确诊HIE者36例,以HIE患儿为观察组,随机抽取同期正常新生儿50例为对照组,比较两组脐动脉血气指标及出生后2~3天、12~14天、26~28天NBNA评分。36例HIE患儿随访6个月,用Gesell发育量表评估其短期预后,回顾性分析预后良好组和预后不良组的脐动脉血气分析指标和NBNA评分情况,采用ROC分析相关指标对HIE短期预后的预测价值。结果HIE组和对照组脐动脉血气分析指标[pH、氧分压(PO_(2))、二氧化碳分压(PCO_(2))、碱剩余(BE)和碳酸氢根(HCO-3)]和3个时间点NBNA评分差异均有统计学意义(P<0.05)。预后良好组和预后不良组的脐动脉血气分析指标(pH、PO_(2)、PCO_(2)和BE)和2个时间点(12~14天及26~28天)NBNA评分差异有统计学意义(P<0.05);pH、PO_(2)、12~14天和26~28天NBNA评分对新生儿HIE短期预后有预测价值。结论pH、PO_(2)、12~14天和26~28天NBNA评分能作为预测HIE患儿短期预后的重要指标。Aim To explore the predictive value of umbilical artery blood gas analysis(UABGA)and neurobehavioral(NBNA)score in the short-term prognosis of neonatal hypoxic-ischemic encephalopathy(HIE).Methods 1877 full-term newborns delivered were randomly selected,and 36 cases were diagnosed with HIE.Taking HIE newborns as the observation group and 50 normal children in the same period as the control group,the umbilical artery blood gas indexes and NBNA scores at three time points(day 2-3,day 12-14 and day 26-28 after birth)were compared between the two groups.36 newborns with HIE were followed up for 6 month and the short-term prognosis was evaluated by Gesell development scale.The umbilical artery blood gas analysis indexes and NBNA scores at three time points in the good prognosis group and poor prognosis group were analyzed retrospectively.The predictive value of relevant indexes in the short-term prognosis of HIE was analyzed by ROC.Results There were significant differences in umbilical artery blood gas analysis indexes[pH,oxygen pressure(PO_(2)),carbon dioxide pressure(PCO_(2)),base excess(BE)and bicarbonate(HCO-3)]and NBNA scores at three time points between HIE group and normal control group(P<0.05).There was significant difference in umbilical artery blood gas analysis indexes(pH,PO_(2),PCO_(2)and BE)and NBNA score at two time points(12-14 d and 26-28 d)between good prognosis group and poor prognosis group(P<0.05).The AUC of ROC curve of pH,PO_(2),12-14 days and 26-28 days were 0.763,0.712,0.761 and 0.758,respectively.Conclusion pH,PO_(2),day 12-14 and day 26-28 NBNA scores can be used as important indexes to predict the short-term prognosis of HIE.

关 键 词：新生儿 缺氧缺血性脑病 脐动脉血气分析 神经行为评分 预后 

分 类 号：R748[医药卫生—神经病学与精神病学]