The Value Of Different Detection Indexes In Predicting The Prognosis Of Neonatal Bilirubin Brain Injury

Objective To explore the value of head MRI、TSB level,B/A value,NBNA score and Gesell score in early prediction of neonatal bilirubin brain injury;The significance of the above indexes in prognostic evaluation of bilirubin brain injury is to guide clinical diagnosis of the disease more comprehensively and accurately and provide basis for improving long-term development.Method According to the diagnostic criteria for neonatal hyperbilirubinemia formulated by the Neonatology Group of the Chinese Academy of Pediatrics in 2014,148 cases of hyperbilirubinemia who were hospitalized in the Neonatology Department of Anhui Children’s Hospital from January 2021 to June 2022 were selected.Newborns with hyperglycemia were the research objects.All the subjects enrolled in the study completed head MRI examination within 1 week of hospitalization.They were divided into brain injury group according to whether the results of head MRI indicated the presence of bilateral pallidum T1 WI symmetrical hyperintensity.(85 cases)and no brain injury group(63 cases).Collect basic clinical data of all research subjects,including mother’s perinatal information,such as maternal age,abnormal blood sugar during perinatal period,hypertension during pregnancy,gestational age,birth weight,gender,age of jaundice o NSEt,clinical manifestations And laboratory indicators include TSB level,albumin value,B/A value,blood sugar,etc.,and other auxiliary examinations such as brain MRI,BAEP results,and clinical evaluation results,including BIND score,NBNA score,etc.From June 2021 to December 2022,all enrolled patients will go to the Neonatal Follow-up Center and Rehabilitation Department for follow-up,and judge the growth and development of the children through clinical physical examination,Gesell development scale,head MRI,BAEP,etc,and will collect All data were statistically analyzed.Results Transcutaneous bilirubin(19.95 ± 5.05 mg/d L),TSB(316.91 ± 103.29 μmol/L),albumin(37.90 ± 3.65 g/L)B/A(8.35 ± 2.67 mg/g)in brain injury group were significantly higher than those in non-brain injury group 16.40 ± 2.73,276.88 ±67.57,36.28 ± 2.28,7.62 ± 1.67,P<0.05,The incidence of abnormal physical examination in the brain injury group was 20% higher than that in the non-brain injury group(3.2%).The incidence of ABO hemolytic infection and intracranial hemorrhage in the brain injury group was also higher than that in the non-brain injury group(P < 0.05);The abnormal rate of BAEP in brain injury group(24.7%)was higher than that in non-injury group(4.8%).The abnormal rate of muscle tension in brain injury group was higher than that in non-injury group(P < 0.05),The NBNA score(37.86 ± 2.00)Gesell score(79.74 ± 5.32)in brain injury group was lower than that in non-brain injury group(38.75 ± 0.97)Gesell score(83.21 ± 3.45),P < 0.05.B/A value,TSB level,NBNA score and Gesell score were 0.6850.6380.6040.690,respectively.All of them were > 0.5,indicating that they had predictive value.Among them,B/A value and Gesell score predicted the area under ROC curve of brain injury with greater predictive significance than others The sensitivity and specificity were 61.18%,79.37%,49.41%,88.89%,34.12%,92.06%,55.29% and 71.43%,respectively.Conclusion Head MRI,TSB value,B/A value,NBNA score and Gesell score are good indicators to predict the poor prognosis of bilirubinemia brain injury,and have clinical significance for early detection and intervention,curative effect observation and prognosis evaluation of neonatal hyperbilirubinemia brain injury.