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新生儿缺氧缺血性脑病多器官功能障碍的诊断:血管活性药物评分、肾脏评分、纤维化-5指数及乳酸/白蛋白比值

Diagnosis of Multiple Organ Dysfunction in Neonates with Hypoxic-Ischemic Encephalopathy: Vasoactive Inotropic Score, Renal Score, Fibrosis-5 Index and Lactate/Albumin Ratio.

作者信息

Kaya Başak, Akduman Hasan, Dilli Dilek, Ünsal Nilden, Fettah Nurdan Dinlen, Zenciroğlu Ayşegül

机构信息

Department of Neonatology, Dr. Sami Ulus Maternity and Child Research and Training Hospital, Babur st., Number: 36, Altındag 06080, Turkey.

Department of Pediatrics, Dr. Sami Ulus Maternity and Child Research and Training Hospital, Babur st., Number: 36, Altındag 06080, Turkey.

出版信息

Diagnostics (Basel). 2024 Dec 12;14(24):2796. doi: 10.3390/diagnostics14242796.

Abstract

BACKGROUND

Vasoactive inotrope score, renal score, fibrosis-5 index, and lactate-albumin ratio have not been investigated before in determining multiple organ dysfunctions accompanying infants with hypoxic-ischemic encephalopathy (HIE) in neonatal intensive care units (NICUs). The aim of this study was to determine whether multiple organ dysfunctions that may accompany HIE in infants are correlated with vasoactive inotrope score (VIS), renal score (RS), fibrosis-5 index (FIB-5), and lactate-albumin ratio (LAR), and whether these parameters can predict morbidity and mortality.

METHODS

This is a retrospective study, and 106 newborns diagnosed with HIE and treated with hypothermia were included in the study. Vasoactive inotrope score for cardiac dysfunction, renal score for renal dysfunction, fibrosis-5 index, and lactate/albumin ratio for hepatic dysfunction were evaluated.

RESULTS

We found that the vasoactive inotrope score, renal score, fibrosis-5 index, and lactate-albumin ratio values of infants diagnosed with HIE are associated with cardiac, renal, and hepatic dysfunction. These values, calculated on the 2nd postnatal day, are particularly linked to prolonged hospital stay and mortality, which are key prognostic factors.

CONCLUSIONS

Our study is the first to combine vasoactive inotrope score, renal score, fibrosis-5 index, and lactate-albumin ratio parameters in determining organ dysfunction in newborns with hypoxic-ischemic encephalopathy and to reveal their prognostic and mortality prediction values. Therefore, although it offers new perspectives, new studies are needed.

摘要

背景

在新生儿重症监护病房(NICU)中,血管活性正性肌力评分、肾脏评分、纤维化-5指数和乳酸-白蛋白比值在确定伴有缺氧缺血性脑病(HIE)的婴儿的多器官功能障碍方面尚未得到研究。本研究的目的是确定婴儿HIE可能伴随的多器官功能障碍是否与血管活性正性肌力评分(VIS)、肾脏评分(RS)、纤维化-5指数(FIB-5)和乳酸-白蛋白比值(LAR)相关,以及这些参数是否可以预测发病率和死亡率。

方法

这是一项回顾性研究,研究纳入了106例诊断为HIE并接受低温治疗的新生儿。评估了心脏功能障碍的血管活性正性肌力评分、肾功能障碍的肾脏评分、纤维化-5指数以及肝功能障碍的乳酸/白蛋白比值。

结果

我们发现,诊断为HIE的婴儿的血管活性正性肌力评分、肾脏评分、纤维化-5指数和乳酸-白蛋白比值与心脏、肾脏和肝功能障碍相关。在出生后第2天计算的这些值尤其与延长住院时间和死亡率相关,而这两个因素是关键的预后因素。

结论

我们的研究首次将血管活性正性肌力评分、肾脏评分、纤维化-5指数和乳酸-白蛋白比值参数结合起来,用于确定缺氧缺血性脑病新生儿的器官功能障碍,并揭示了它们的预后和死亡率预测价值。因此,尽管本研究提供了新的视角,但仍需要开展新的研究。

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