Thompson C M, Puterman A S, Linley L L, Hann F M, van der Elst C W, Molteno C D, Malan A F
Department of Paediatrics and Child Health, University of Cape Town, South Africa.
Acta Paediatr. 1997 Jul;86(7):757-61. doi: 10.1111/j.1651-2227.1997.tb08581.x.
A numeric scoring system for the assessment of hypoxic ischaemic encephalopathy during the neonatal period was tested. The value of the score in predicting neurodevelopmental outcome at 1 y of age was assessed. Forty-five infants who developed hypoxic ischaemic encephalopathy after birth were studied prospectively. In addition to the hypoxic ischaemic encephalopathy score all but two infants had at least one cranial ultrasound examination. Thirty-five infants were evaluated at 12 months of age by full neurological examination and the Griffiths Scales of Mental Development. Five infants were assessed at an earlier stage, four who died before 6 months of age and one infant who was hospitalized at the time of the 12 month assessment. Twenty-three (58%) of the infants were normal and 17 (42%) were abnormal, 16 with cerebral palsy and one with developmental delay. The hypoxic ischaemic encephalopathy score was highly predictive for outcome. The best correlation with outcome was the peak score; a peak score of 15 or higher had a positive predictive value of 92% and a negative predictive value of 82% for abnormal outcome, with a sensitivity and specificity of 71% and 96%, respectively. For the clinician working in areas where sophisticated technology is unavailable this scoring system will be useful for assessment of infants with hypoxic ischaemic encephalopathy and for prognosis of neurodevelopmental outcome.
对一种用于评估新生儿期缺氧缺血性脑病的数字评分系统进行了测试。评估了该评分在预测1岁时神经发育结局方面的价值。对45例出生后发生缺氧缺血性脑病的婴儿进行了前瞻性研究。除缺氧缺血性脑病评分外，除两名婴儿外，其他所有婴儿均至少接受了一次头颅超声检查。35例婴儿在12个月大时通过全面的神经学检查和格里菲斯智力发育量表进行评估。5例婴儿在更早阶段接受了评估，4例在6个月前死亡，1例在12个月评估时住院。23例（58%）婴儿正常，17例（42%）异常，其中16例患有脑瘫，1例发育迟缓。缺氧缺血性脑病评分对结局具有高度预测性。与结局相关性最好的是峰值评分；峰值评分15分或更高时，异常结局的阳性预测值为92%，阴性预测值为82%，敏感性和特异性分别为71%和96%。对于在没有先进技术的地区工作的临床医生来说，这种评分系统将有助于评估缺氧缺血性脑病婴儿并预测神经发育结局。
