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。%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.
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