Jones Rebekka, Heep Axel, Odd David
a Neonatal Intensive Care Unit , Southmead Hospital, North Bristol NHS Trust , Bristol , UK.
b University of Bristol , Bristol , UK.
J Matern Fetal Neonatal Med. 2018 Mar;31(6):791-796. doi: 10.1080/14767058.2017.1297790. Epub 2017 Mar 8.
To determine the usefulness of measures, available shortly after birth, as predictors of hypoxic-ischemic encephalopathy (HIE) following perinatal asphyxia.
All inborn patients at Southmead Hospital between January 2012 and March 2014 at ≥36 weeks gestation with a pH <7 or BE >16 on cord or baby's blood within one hour of birth or 10-minute Apgar score ≤5 or requiring intermittent positive pressure ventilation at 10 minutes were eligible for inclusion.
ROC curves were derived for the perinatal clinical and biochemical measures to establish their predictive values for the development of HIE and the area under the curve (AUC) used as the measure of prediction.
We identified 79 eligible babies. Infants qualifying for therapeutic hypothermia (TH) based on aEEG abnormalities were considered to have HIE (n = 13; 16.5%), whereas babies with normal aEEG were classified as "non-HIE" (n = 66; 83.5%). The highest AUC measure was associated with the five-minute Apgar score (0.89 (0.79-0.99)). Troponin T (0.81 (0.64-0.98)) and ALT (0.78 (0.60-96)) also showed high values.
In this work, the Apgar score, troponin T and ALT were found to be strong and useful predictors of HIE.
确定出生后不久即可获得的指标作为围产期窒息后缺氧缺血性脑病（HIE）预测指标的效用。
2012年1月至2014年3月在索斯米德医院出生的所有胎龄≥36周的新生儿，出生后1小时内脐带血或婴儿血pH<7或碱剩余>16，或10分钟Apgar评分≤5，或出生后10分钟需要间歇性正压通气的患者均符合纳入标准。
绘制围产期临床和生化指标的ROC曲线，以确定其对HIE发生的预测价值，并将曲线下面积（AUC）用作预测指标。
我们确定了79名符合条件的婴儿。根据振幅整合脑电图（aEEG）异常符合治疗性低温（TH）标准的婴儿被认为患有HIE（n = 13；16.5%），而aEEG正常的婴儿被归类为“非HIE”（n = 66；83.5%）。最高的AUC指标与5分钟Apgar评分相关（0.89（0.79 - 0.99））。肌钙蛋白T（0.81（0.64 - 0.98））和谷丙转氨酶（ALT）（0.78（0.60 - 0.96））也显示出较高的值。
在本研究中，发现Apgar评分、肌钙蛋白T和ALT是HIE强有力且有用的预测指标。
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