胆红素总量/白蛋白比值、听力筛查及MRI-T_(1)WI影像对新生儿急性胆红素脑病的诊断价值  

Diagnostic Value of Total Bilirubin/Albumin Ratio,Hearing Screening and MRI-T_(1)WI Imaging in Neonatal with Acute Bilirubin Encephalopathy

作　　者：王粉[1] 王燕 顾圆 王倩倩 陈志云 田小娟 WANG Fen;WANG Yan;GU Yuan;WANG Qianqian;CHEN Zhiyun;TIAN Xiaojuan(Taicang First People's Hospital,Taicang 215400,China;不详)

机构地区：[1]太仓市第一人民医院,江苏太仓215400

出　　处：《中外医学研究》2024年第4期143-148,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2018年度苏州市“科教兴卫”青年科技项目(KJXW2018065)。

摘　　要：目的:探究胆红素总量/白蛋白比值(B/A)、听力筛查及磁共振成像-T_(1)加权成像(MRI-T_(1)WI)对新生儿急性胆红素脑病(ABE)的诊断价值。方法:选取2013年6月—2023年6月于太仓市第一人民医院接受治疗的136例新生儿高胆红素血症(NHB)患儿作为研究对象,根据是否并发ABE分为并发组(n=42)和对照组(n=94)。对比两组的临床资料、B/A水平、听力筛查结果、苍白球T_(1)WI信号强度,对单因素分析有意义的指标进行多因素logistic回归分析,采用ROC曲线分析其对新生儿ABE的诊断价值。结果:并发组总血清胆红素(TSB)峰值、B/A水平均高于对照组,差异有统计学意义(P<0.05)。并发组初筛听力异常率为38.10%,复筛听力异常率为35.71%,均高于对照组的18.09%、8.51%,差异有统计学意义(P<0.05)。并发组苍白球与额叶脑皮质T_(1)WI信号强度比值(G/Gr)水平高于对照组,差异有统计学意义(P<0.05)。logistic回归分析显示,B/A、听力异常和G/Gr水平表达均为影响NHB患儿并发ABE的独立危险因素,差异有统计学意义(P<0.05)。ROC曲线分析显示,B/A、G/Gr、听力异常及三者联合检测NHB患儿并发ABE的AUC值分别为0.773、0.652、0.754、0.863,有较高诊断价值,且联合诊断价值最高(P<0.05)。结论:ABE患儿中B/A、听力异常和G/Gr表达水平明显升高,三者单独和联合检测NHB患儿并发ABE均有较高诊断价值,其中三者联合诊断效果最佳。Objective:To explore the diagnostic value of total bilirubin/albumin ratio(B/A),hearing screening and magnetic resonance image-T_(1)-weighted imaging(MRI-T_(1)WI)in neonatal with acute bilirubin encephalopathy(ABE).Method:A total of 136 neonatal hyperbilirubinemia(NHB)children treated in Taicang First People's Hospital from June 2013 to June 2023 were selected as the study objects,and they were divided into the concurrent group(n=42)and the control group(n=94)according to whether neonatal ABE was complicated.The clinical data,B/A levels,hearing screening results,and pallidus T_(1)WI signal intensity of the two groups were compared.Multivariate logistic regression analysis was performed for the indicators that had significance in univariate analysis,and ROC curve was used to analyze their diagnostic value in neonatal with ABE.Result:The peak value of total serum bilirubin(TSB)and B/A level in concurrent group were higher than those in control group,the differences were statistically significant(P<0.05).The rate of hearing abnormality in the concurrent group was 38.10%at the first screening,and 35.71%at the re-screening,both higher than 18.09%and 8.51%in the control group,and the differences were statistically significant(P<0.05).The ratio of T_(1)WI signal intensity between globus pallidus and frontal cortex(G/Gr)of the concurrent group was higher than that of the control group,and the difference was statistically significant(P<0.05).logistic regression analysis showed that B/A,hearing abnormality and G/Gr level were independent risk factors for ABE in NHB children,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the AUC values of B/A,G/Gr,hearing abnormality and their combined detection of NHB complicated ABE were 0.773,0.652,0.754 and 0.863,respectively,which had high diagnostic value,and the combined diagnosis value was the highest(P<0.05).Conclusion:The expression levels of B/A,hearing abnormality and G/Gr in children with ABE were significantly increased,and the three

关 键 词：急性胆红素脑病 新生儿 胆红素总量/白蛋白比值 听力筛查 磁共振成像-T_(1)加权成像 

分 类 号：R722.1[医药卫生—儿科]