摘要
目的 探究高胆红素血症(HB)新生儿的苍白球/壳核(G/P)T1WI信号强度比值的影响因素并构建模型预测急性胆红素脑病(ABE)的发生风险.方法 回顾性分析2017年7月-2022年12月在我院接受颅脑MR检查的HB新生儿140例及ABE新生儿3例.收集两组临床资料包括性别、年龄、胎龄、出生体重、血清总胆红素(TB)、血清总胆红素/白蛋白(B/A)、是否具有感染或败血症、是否具有ABO溶血、是否具有葡萄糖-6-磷酸脱氢酶(G6PD)缺乏及是否具有酸中毒.构建Logistic回归模型筛选出HB新生儿G/P比值的影响因素,并探究基于HB新生儿G/P比值的多重回归方程能否预测ABE的发生风险.结果 年龄OR=0.747(95％CI 0.674-0.828),胎龄OR=0.942(95％CI 0.905-0.981)及血清总胆红素OR=1.004(95％CI 1.000-1.008)是 HB 新生儿 G/P 比值的影响因素,基于HB新生儿的多重线性回归方程为 Y(预测 G/P)=2.945-0.018 × X1(年龄)-0.004 × X2(胎龄)+0.0003 × X3(血清总胆红素).G/P比值的实测值较预测值升高8％以上时,需要警惕ABE发生风险.结论 年龄、胎龄及血清总胆红素是HB新生儿G/P比值的影响因素,基于HB新生儿的G/P构建的多重线性回归模型能预测ABE发生风险.
Abstract
Objective To explore the factors influencing the globus pallidus/putamen(G/P)T1WI signal intensity ratio in neonates with hyperbilirubinemia(HB)and to build a model for predicting the risk of acute bilirubin encephalopathy(ABE).Methods A retrospective analysis was performed on 140 cases of HB neonates and 3 cases of ABE neonates who received cranial MR examination in our hospital from July 2017 to December 2022.Clinical data were collected for both groups including sex,age,gestational age,birth weight,Serum total bilirubin(TB),serum total bilirubin/albumin(B/A)ratio,the presence or absence of neonatal infection or sepsis,ABO hemolysis,glucose-6-phosphate dehydrogenase(G6PD)deficiency,and acidosis.A Logistic regression model was constructed to screen out the influencing factors of G/P ratio in HB neonatal,and to explore whether multiple regression equation based on G/P ratio of HB neonatal could predict the risk of BE.Results Age[OR=0.747(95％CI 0.674-0.828)],gestational age[OR=0.942(95％CI 0.905-0.981)]and serum total bilirubin[OR=1.004(95％CI 1.000-1.008)]were the influencing factors of G/P ratio in HB neonatal.The multiple linear regression equation was of HB neonatal was Y(predicted G/P)=2.945-0.018x×X1(age)-0.004×X2(gestational age)+0.0003×X3(total serum bilirubin).When measurement value of G/P ratio is 8％higher than that of predicted value,attention should be paid to the risk of ABE.Conclusion Age,gestational age and serum total bilirubin are the factors influencing the G/P ratio of HB neonates,and the multiple linear regression model based on the G/P ratio of HB neonates can predict the risk of ABE.
基金项目
国家自然科学基金(82160330)
江西省自然科学基金(20202ACBL216006)
赣州市科技计划(2022-ZD1373)
赣州市卫生健康委市级科研项目(GZWJW202402120)
万方数据