| 丁海燕,陈 琪,孙 婷,熊 丽,张连红.重度新生儿高胆红素血症发生急性胆红素脑病的危险因素及头颅磁共振G/P值联合血清TSB、NSE的预测价值研究[J].,2023,(19):3719-3723 |
| 重度新生儿高胆红素血症发生急性胆红素脑病的危险因素及头颅磁共振G/P值联合血清TSB、NSE的预测价值研究 |
| Risk Factors for the Acute Bilirubin Encephalopathy Occurrence in Severe Neonatal Hyperbilirubinemia and the Predictive Value Study of Cranial Magnetic Resonance G/P Value Combined with Serum TSB and NSE |
| 投稿时间：2023-02-25 修订日期：2023-03-28 |
| DOI：10.13241/j.cnki.pmb.2023.19.024 |
| 中文关键词: 新生儿高胆红素血症 急性胆红素脑病 G/P值 TSB NSE 预测价值 |
| 英文关键词: Neonatal hyperbilirubinemia Acute bilirubin encephalopathy G/P value TSB NSE Predictive value |
| 基金项目:湖北省卫生健康委科研基金项目（WJ2019H208） |
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| 中文摘要: |
| 摘要 目的：分析重度新生儿高胆红素血症（NHB）发生急性胆红素脑病（ABE）的危险因素并探讨头颅磁共振苍白球与壳核T1加权成像信号强度比值（G/P值）联合血清总胆红素（TSB）、神经元特异性烯醇化酶（NSE）的预测价值。方法：选取2018年1月～2020年1月湖北省天门市第一人民医院收治的369例重度NHB患儿，根据入院1周内是否发生ABE分为ABE组和非ABE组。收集所有患儿临床资料，计算头颅磁共振G/P值和检测血清TSB、NSE水平。采用单因素和多因素Logistic回归分析重度NHB发生ABE的影响因素，受试者工作特征（ROC）曲线分析头颅磁共振G/P值联合血清TSB、NSE对重度NHB发生ABE的预测价值。结果：369例NHB患儿ABE发生率为12.47％（46/369）。多因素Logistic回归分析显示，出生体重较低、入院日龄缩短、住院时间延长、非母乳喂养、血红蛋白升高和G/P值、TSB、NSE升高为重度NHB发生ABE的独立危险因素（P＜0.05）。ROC曲线分析显示，头颅磁共振G/P值联合血清TSB、NSE预测重度NHB发生ABE的曲线下面积大于头颅磁共振G/P值和血清TSB、NSE单独预测（P＜0.05）。结论：出生体重较低、入院日龄缩短、住院时间延长、非母乳喂养、血红蛋白升高、G/P值升高、TSB升高、NSE升高是重度NHB发生ABE的危险因素，头颅磁共振G/P值联合血清TSB、NSE预测ABE的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors for the acute bilirubin encephalopathy (ABE) occurrence in severe neonatal hyperbilirubinemia (NHB) and to investigate the predictive value of cranial magnetic resonance pale globule to shell nucleus T1-weighted imaging signal intensity ratio (G/P value) combined with total serum bilirubin (TSB) and neuron-specific enolase (NSE). Methods: 369 children with severe NHB who were admitted to the Tianmen First People's Hospital of Hubei Province from January 2018 to January 2020 were selected, and they were divided into ABE group and non-ABE group according to whether ABE occurred within 1 week after admission. Clinical data of all children were collected, the cranial magnetic resonance G/P value were calculated, and serum TSB and NSE levels were detected. Univariate and multivariate Logistic regression were used to analyze the influencing factors of ABE occurrence in severe NHB. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of cranial magnetic resonance G/P value combined with serum TSB and NSE for ABE occurrence in severe NHB. Results: The incidence of ABE in 369 children with NHB was 12.47% (46/369). Multivariate Logistic regression analysis showed that lower birth weight, shorter hospital admission days, longer hospital stay, non-breastfeeding, increased hemoglobin and G/P value, increased TSB and NSE were independent risk factors for ABE occurrence with severe NHB (P＜0.05). ROC curve analysis showed that the area under curve predicted ABE occurrence of severe NHB by G/P value combined with serum TSB and NSE was larger than that predicted by G/P value combined with serum TSB and NSE alone (P＜0.05). Conclusion: Lower birth weight, shorter hospital admission days, longer hospital stay, non-breastfeeding, increased hemoglobin, increased G/P value, increased TSB and increased NSE are risk factors for ABE occurrence in severe NHB. The value of cranial magnetic resonance G/P value combined with serum TSB and NSE is higher in predicting ABE. |
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