Diagnostic value of color Doppler ultrasound combined with serum NSE and 5 min Apgarscore in neonatal intracranial hemorrhage and analysis of risk factors
Yan Yonglei, He Yangyang, Liang Zhenzhen, et al
(Department of Neonatology, Chengde Central Hospital, Hebei, Chengde 067000, China)
Abstract: 【Abstract】 Objective To investigate the diagnostic value of color Doppler ultrasound combined with neuron-specific enolase (NSE) and 5 min Apgar score in neonatal intracranial hemorrhage (ICH) and risk factors affecting the occurrence of ICH. Method A total of 253 neonates who underwent color Doppler ultrasound examination to the Department of Neonatology, Chengde Central Hospital from February 2019 to March 2021 were enrolled as study subjects, and they were divided into ICH group (n=99) and non-ICH group (n=154)according to the presence or absence of ICH. The two sets of color Doppler ultrasound parameters [peak systolicvelocity (PSV), resistance index (RI), end diastolic velocity (EDV)], serum NSE level, 5 min Apgar score wereobserved and compared, and the correlation between of Apgar score, color Doppler ultrasound parameters and NSElevel were analyzed. The diagnostic value of the combination of the three in neonatal ICH were analyzed,and the risk factors affecting the occurrence of ICH were analyzed. The statistical methods performedby independent sample t-test, χ2 test, Pearson correlation analysis, Logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Result PSV [(6.4±1.2) cm/s vs (10.1±1.4) cm/s, t=21.628]and RI (0.6±0.1 vs 0.7±0.1, t=8.144), EDV[(2.5±0.4) cm/s vs (3.1±0.4) cm/s, t=13.216] and 5 min Apgarscore [(6.5±1.7) points vs (8.8±1.0) points, t=13.308] in ICH group were significantly lower than those innon-ICH group (all P<0.05), and the serum NSE level was significantly higher than that of non-ICH group[(149.1±10.6) μg/L vs (95.2±10.4) μg/L, t=40.015, P<0.001]. The serum NSE levels in the ICH group were negatively correlated with the color Doppler ultrasound parameters PSV, RI and EDV (r=-0.573, -0.520,-0.536, all P<0.05), and the 5 min Apgar score was positively correlated with the color Doppler ultrasoundparameters PSV, RI and EDV (r=0.601, 0.529, 0.505, all P<0.05). The results of the ROC curve showed thatthe area under the curve (AUC) of color doppler ultrasound, serum NSE and 5 min Apgar score combinedto diagnose neonatal ICH was the largest, which was 0.861. Univariate analysis showed that children in theICH group had a smaller gestational age, lower birth weight, lower 5 min Apgar score, higher proportion ofbirth apnea, dopamine, mechanical ventilation and serum NSE levels compared with the non-ICH group (allP<0.05). Multivariate Logistic regression analysis showed that gestational age <32 weeks, birth weight<1 500 g, serum NSE level >117.95 μg/L, and 5 min Apgar score <7 points were independent risk factorsfor ICH. Conclusion Color Doppler ultrasound combined with serum NSE and 5 min Apgar score canimprove the diagnostic value of ICH. Gestational age <32 weeks, birth weight <1 500 g, serum NSE level>117.95 μg/L, and 5 min Apgar score <7 points are independent risk factors for ICH.
闫永垒 贺洋洋 梁真真 张晶 黄萍虹 田晓玲 苏金玲 陈丽祺. 彩色多普勒超声联合血清NSE及5 minApgar评分对新生儿颅内出血的诊断价值及危险因素分析[J]. 发育医学电子杂志, 2024, 12(3): 166-171.
Yan Yonglei, He Yangyang, Liang Zhenzhen, et al. Diagnostic value of color Doppler ultrasound combined with serum NSE and 5 min Apgarscore in neonatal intracranial hemorrhage and analysis of risk factors. Journal of Developmental Medicine(Electronic Version), 2024, 12(3): 166-171.