Prognostic evaluation value of NLR and RDW combined with amplitude integrated electroencephalogram in children with hypoxic ischemic encephalopathy

doi:10.3877/cma.j.issn.2095-123X.2023.02.003

Abstract

Abstract:

Objective

To explore the prognostic value of neutrophil to lymphocyte ratio (NLR), red blood cell distribution width (RDW) combined with amplitude integrated electroencephalogram (aEEG) score in neonatal hypoxic ischemic encephalopathy (HIE).

Methods

A retrospective analysis was conducted on the clinical data of 76 HIE newborns admitted to the neonatal intensive care unit of Luzhou People's Hospital from October 2017 to October 2019 (HIE neonatal group), and 78 healthy newborns born in the same period were selected as the control group. The NLR, RDW and aEEG scores of the two groups of newborns were compared. The value of drawing receiver operating characteristic curve curves to analyze NLR, RDW levels, and aEEG scores in predicting the prognosis of HIE newborns.

Results

Compared with the control group, the levels of NLR and RDW in HIE groups with different degrees of illness increased (P<0.05); The levels of NLR and RDW in the moderate and severe HIE groups were higher than those in the mild HEI group, while those in the severe HIE group were higher than those in the moderate HIE group (P<0.05). The aEEG abnormal score decreased sequentially with the severity of HIE (P<0.05). The NLR and RDW levels in the death group were higher than those in the survival group, and the aEEG score was lower than that in the survival group (P<0.05). The AUC of NLR, RDW, and aEEG in predicting the prognosis of HIE newborns is 0.889 (95%CI: 0.803-0.964), the optimal cutoff value is 0.784, the sensitivity is 84.54%, and the specificity is 90.43%, all of which are higher than the sensitivity and specificity of individual indicators.

Conclusion

The combination of NLR and RDW levels with aEEG score is helpful in clinical evaluation of the prognosis of neonatal HIE, and is worthy of clinical promotion.

Key words: Hypoxic ischemic encephalopathy, Nneonatal, Neutrophil to lymphocyte ratio, Red blood cell distribution width, Amplitude integrated electroencephalogram

Yulan Liang, Liang Chen, Lingmei Zeng. Prognostic evaluation value of NLR and RDW combined with amplitude integrated electroencephalogram in children with hypoxic ischemic encephalopathy[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(02): 84-89.

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References 27

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组别	例数	性别（男/女）	胎龄（周，Mean±SD）	出生体质量（g，Mean±SD）
对照组	78	44/34	38.27±1.35	3038.0±704.0
HIE新生儿组	76	43/33	37.96±1.28	3055.0±613.0
χ²/t值		0.000	0.840	1.326
P值		1.000	0.359	0.316

组别	例数	性别（男/女）	胎龄（周，Mean±SD）	出生体质量（g，Mean±SD）
对照组	78	44/34	38.27±1.35	3038.0±704.0
HIE新生儿组	76	43/33	37.96±1.28	3055.0±613.0
χ²/t值		0.000	0.840	1.326
P值		1.000	0.359	0.316

组别	例数	NLR	RDW（%）	aEEG评分(分)
对照组	78	2.49±0.64	14.53±1.85	11.35±1.25
HIE新生儿组	76	3.74±0.66	19.34±1.63	8.81±1.34
t值		9.563	11.243	6.704
P值		<0.001	<0.001	<0.001

组别	例数	NLR	RDW（%）	aEEG评分(分)
对照组	78	2.49±0.64	14.53±1.85	11.35±1.25
HIE新生儿组	76	3.74±0.66	19.34±1.63	8.81±1.34
t值		9.563	11.243	6.704
P值		<0.001	<0.001	<0.001

组别	例数	NLR	RDW（%）	aEEG评分（分）
轻度HIE组	35	2.72±0.80	15.52±2.21	9.53±2.20
中度HIE组	28	3.43±0.72^a	17.63±2.41^a	8.23±2.53^a
重度HIE组	13	4.85±1.21^ab	19.81±3.01^ab	7.54±2.45^ab
F值		7.743	5.891	5.673
P值		<0.001	<0.001	<0.001

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