aEEG及NCIS预测早产儿败血症相关性脑病的比较  

Comparison of aEEG and NCIS in predicting sepsis-associated encephalopathy in premature infants

作　　者：卢俊杰[1] 李书书 张俊[1] 李萌萌[1] 陈小慧[1] Lu Junjie;Li Shushu;Zhang Jun;Li Mengmeng;Chen Xiaohui(Department of Pediatrics,Nanjing Maternity Hospital Affiliated to Nanjing Medical University,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)新生儿科,南京210004

出　　处：《脑与神经疾病杂志》2024年第5期312-317,共6页Journal of Brain and Nervous Diseases

基　　金：江苏省高层次卫生人才“六个一工程”拔尖人才项目(LGY2019008)。

摘　　要：目的 比较振幅整合脑电图(aEEG)及新生儿危重病例评分(NCIS)预测早产儿败血症相关性脑病(SAE)的诊断价值。方法 选择2020年9月至2022年10月南京医科大学附属妇产医院新生儿重症监护病房(NICU)收治且病情最严重期间进行了aEEG监测的败血症早产儿为研究对象,根据SAE诊断标准,将47例败血症早产儿分为SAE组24例和非SAE组23例。两组败血症早产儿aEEG检查同时进行NCIS,比较两组患儿的一般资料、母孕期并发症、最差血气分析及aEEG监测时一般情况、疾病危重状况的差异,以及aEEG各参数的连续性、周期性、下边界振幅、带宽及总分和校正总分的差异。绘制SAE受试者工作特征(ROC)曲线,计算灵敏度、特异度和曲线下面积(AUC)。根据约登指数,比较NCIS和aEEG预测SAE的诊断价值。结果 两组败血症早产儿的一般资料、母孕期并发症、最差血气分析,及aEEG检查时的一般情况间的差异均无统计学意义(^(均)P>0.05),而NCIS、aEEG的连续性、周期性、下边界振幅、带宽、总分,均有统计学差异(^(均)P<0.05)。NCIS、aEEG的连续性、周期性、下边界振幅、带宽、aEEG总分,诊断SAE的AUC分别:0.727、0.726、0.884、0.706、0.849、0.890,约登指数分别0.406、0.703、0.703、0.412、0.746、0.701。结论 NCIS、aEEG连续性、周期性、带宽、总分,对诊断SAE有早期预测价值,aEEG比NCIS预测SAE效能更佳。Objective To compare the diagnostic value of amplitude-integrated electroencephalography(aEEG) and neonatal critical illness score(NCIS) in predicting sepsis-associated encephalopathy(SAE) of premature infants.Methods Premature infants with septicemia who underwent aEEG monitoring during the most severely condition in the neonatal intensive care unit(NICU) of Maternity Hospital Affiliated to Nanjing Medical University from September 2020 to October 2022 were selected as subjects.According to the diagnostic criteria of SAE,47 premature infants with septicemia were divided into the SAE group(24 cases) and the non-SAE group(23 cases).The two groups of premature infants with septicemia underwent aEEG monitoring and NCIS.The two groups were compared for differences in general information,maternal complications during pregnancy,and the worst blood gas analysis.General information and critical conditions while aEEG monitoring were compared between the two groups.The continuity,periodicity,lower boundary amplitude,bandwidth,total score,and correction total score of aEEG parameters were analyzed and compared between the two groups.The receiver operating characteristic(ROC) curve of SAE was plotted and sensitivity,specificity,and area under the curve(AUC) were calculated.The diagnostic value of NCIS and aEEG in predicting SAE was compared according to the Yoden index.Results There were no significant differences between the two groups in general information,maternal complications,the worst blood gas analysis,and general status during aEEG monitoring(P> 0.05),but there were significant differences in NCIS and the continuity,periodicity,lower boundary amplitude,bandwidth,and total score of aEEG between the two groups(P <0.05).The AUCs of NCIS,Continuity,periodicity,lower boundary amplitude,bandwidth,and total score of aEEG for diagnosing SAE are as follows:0.727,0.726,0.884,0.706,0.849,0.890,and the Yoden index were 0.406,0.703,0.703,0.412,0.746,0.701,respectively.Conclusions NCIS,and continuity,periodicity,bandwidth,and tot

关 键 词：败血症相关性脑病 早产儿 新生儿败血症 振幅整合脑电图 危重病例评分 

分 类 号：R741.044[医药卫生—神经病学与精神病学]