南昌大学学报(医学版)
南昌大學學報(醫學版)
남창대학학보(의학판)
ACTA ACADEMIAE MEDICINAE JIANGXI
2015年
2期
25-31
,共7页
徐文慧%刘娜娜%柳涛%陈晓%罗时文
徐文慧%劉娜娜%柳濤%陳曉%囉時文
서문혜%류나나%류도%진효%라시문
改良 aEEG 评分%新生儿危重病例评分%新生儿急性生理学评分围产期补充-Ⅱ%高危儿%脑损伤
改良 aEEG 評分%新生兒危重病例評分%新生兒急性生理學評分圍產期補充-Ⅱ%高危兒%腦損傷
개량 aEEG 평분%신생인위중병례평분%신생인급성생이학평분위산기보충-Ⅱ%고위인%뇌손상
modified amplitude-integrated EEG score%neonatal critical illness score%neonatal acute physiology perinatal supplement-Ⅱ%high risk infant%brain injury%early diagnosis
目的:探讨改良振幅整合脑电图(aEEG)评分、新生儿危重病例评分(NCIS)和新生儿急性生理学评分围产期补充-Ⅱ(SNAPPE-Ⅱ)在高危儿脑损伤早期诊断中的应用价值。方法回顾性分析119例具有脑损伤高危因素的足月儿临床资料,并于生后12 h 内进行相应评分。比较无脑损伤组与脑损伤组之间各评分分值的差异,并描绘受试者工作特征曲线(ROC),得出3种评分预测高危儿脑损伤的最佳值。结果119例高危儿中,65例(54.6%)发生脑损伤。脑损伤组的改良 aEEG 评分和 NCIS 评分均明显低于无脑损伤组(均 P <0.001),而 SNAPPE-Ⅱ评分明显高于无脑损伤组(P <0.001)。改良 aEEG 评分、NCIS 和 SNAPPE-Ⅱ评分对脑损伤的最佳预测值分别为9、95和22。结论3种评分系统均可作为围产期高危儿脑功能监测的工具,对高危儿脑损伤的早期诊断具有重要意义。
目的:探討改良振幅整閤腦電圖(aEEG)評分、新生兒危重病例評分(NCIS)和新生兒急性生理學評分圍產期補充-Ⅱ(SNAPPE-Ⅱ)在高危兒腦損傷早期診斷中的應用價值。方法迴顧性分析119例具有腦損傷高危因素的足月兒臨床資料,併于生後12 h 內進行相應評分。比較無腦損傷組與腦損傷組之間各評分分值的差異,併描繪受試者工作特徵麯線(ROC),得齣3種評分預測高危兒腦損傷的最佳值。結果119例高危兒中,65例(54.6%)髮生腦損傷。腦損傷組的改良 aEEG 評分和 NCIS 評分均明顯低于無腦損傷組(均 P <0.001),而 SNAPPE-Ⅱ評分明顯高于無腦損傷組(P <0.001)。改良 aEEG 評分、NCIS 和 SNAPPE-Ⅱ評分對腦損傷的最佳預測值分彆為9、95和22。結論3種評分繫統均可作為圍產期高危兒腦功能鑑測的工具,對高危兒腦損傷的早期診斷具有重要意義。
목적:탐토개량진폭정합뇌전도(aEEG)평분、신생인위중병례평분(NCIS)화신생인급성생이학평분위산기보충-Ⅱ(SNAPPE-Ⅱ)재고위인뇌손상조기진단중적응용개치。방법회고성분석119례구유뇌손상고위인소적족월인림상자료,병우생후12 h 내진행상응평분。비교무뇌손상조여뇌손상조지간각평분분치적차이,병묘회수시자공작특정곡선(ROC),득출3충평분예측고위인뇌손상적최가치。결과119례고위인중,65례(54.6%)발생뇌손상。뇌손상조적개량 aEEG 평분화 NCIS 평분균명현저우무뇌손상조(균 P <0.001),이 SNAPPE-Ⅱ평분명현고우무뇌손상조(P <0.001)。개량 aEEG 평분、NCIS 화 SNAPPE-Ⅱ평분대뇌손상적최가예측치분별위9、95화22。결론3충평분계통균가작위위산기고위인뇌공능감측적공구,대고위인뇌손상적조기진단구유중요의의。
ABSTRACT:Objective To explore the early diagnostic values of modified amplitude-integrated electroencephalogram(aEEG)score,neonatal critical illness score (NCIS)and neonatal acute physiology perinatal supplement-Ⅱ(SNAPPE-Ⅱ)score in neonates at high risk for brain injury. Methods The clinical data of 119 term neonates at high risk for brain injury are retrospectively analyzed.The scores for modified aEEG,NCIS and SNAPPE-Ⅱ were evaluated within the first 12 postnatal hours.The score differences were compared between the non-brain injury group and brain injury group.The predictive accuracy of these parameters in brain injury was expressed as area under the curve(AUC)of receiver operating characteristic(ROC).Furthermore,ROC was used to predict the optimal value of neonatal brain injury.Results Of the 119 neonates evaluated, 65 cases(54.6%)had brain injury.Both modified aEEG and NCIS scores in brain injury group were lower than those in non-brain injury group(P <0.001).However,SNAPPE-Ⅱ score in brain injury group was higher than that in non-brain injury group(P <0.001).As measured by modified aEEG,NCIS and SNAPPE-Ⅱ,the optimal predictor values were 9,95 and 22,respectively.Con-clusion The aEEG,NCIS and SNAPPE-Ⅱ can be used as tools for brain function monitoring and have great significance in the early diagnosis of brain injury in neonates at high risk for brain injury.