两种危重评分对新生儿呼吸窘迫综合征患儿死亡风险的预测价值

Value of two kinds of scores in prediction of mortality risk of neonatal respiratory distress syndrome

摘要:

摘要：目的  探讨新生儿急性生理学评分围生期补充Ⅱ（SNAPPE-Ⅱ）和新生儿危重病例评分（NCIS）对新生儿呼吸窘迫综合征（RDS）患儿死亡风险的预测价值。方法  采用SNAPPE-Ⅱ和NCIS评分对118例RDS新生儿进行评估，描绘两种评分方法的受试者工作曲线（ROC），探讨两种评分的相关性及预测新生儿RDS死亡风险的价值。结果  死亡组的SNAPPE-Ⅱ为（28.06±8.77）分，高于生存组的（14.28±10.95）分，NCIS评分为（84.84±3.77）分，低于生存组的（90.38±4.70）分，组间两种评分比较，差异有统计学意义（t =7.332和7.098，P =0.000）；两种评分呈负相关（r =-0.522，P =0.000）；采用ROC曲线分析SNAPPE-Ⅱ及NCIS评分预测RDS患儿死亡风险的价值，SNAPPE-Ⅱ的ROC曲线下面积为0.841[（95%CI：0.796，0.912）P =0.000]，SNAPPE-Ⅱ22.5分为预测RDS死亡的最佳界值；调整后NCIS评分的ROC曲线下面积为0.829[（95%CI：0.754，0.903）P =0.000]，NCIS评分89.0分为预测RDS死亡的最佳界值。结论  SNAPPE-Ⅱ和NCIS评分对新生儿呼吸窘迫综合征死亡风险均有预测作用，SNAPPE-Ⅱ评分越高，NCIS评分越低，RDS患儿死亡的风险越大，其中SNAPPE-Ⅱ预测死亡风险的能力更强，对RDS患儿死亡风险评估更为合适。

Abstract:

Abstract: Objective To investigate the value of scores for Neonatal Acute Physiology, Perinatal Extension Version Ⅱ (SNAPPE-Ⅱ) and Neonatal Critical Illness Score (NCIS) in prediction of mortality risk of neonatal respiratory distress syndrome (RDS). Methods The 118 cases of neonates with RDS were scored by SNAPPE-Ⅱ and NCIS. The receiver operating characteristic curves (ROC) of the two methods were described. The correlation of the two scores, and the value of the two scores in prediction of the mortality risk of neonatal RDS were explored. Results The average SNAPPE-Ⅱ of the death group was (28.06 ± 8.77), higher than (14.28 ± 10.95) of the survival group. The average NCIS was (84.84 ± 3.77), lower than (90.38 ± 4.70) of the survival group. The two scores were significantly different between the two groups (t = 7.332 and 7.098, P = 0.000); the two scores were negatively correlated (r = -0.522, P = 0.000). Using ROC values of SNAPPE-Ⅱ and NCIS for prediction of the mortality risk of neonatal RDS, the area under the ROC of SNAPPE-Ⅱ was 0.841 [(95% CI: 0.796, 0.912), P = 0.000], SNAPPE-Ⅱ of 22.5 was the best boundary value to predict RDS mortality; the area under the ROC of adjusted NCIS was 0.829 [(95% CI: 0.754, 0.903), P = 0.000], NCIS of 89 was the best cut-off value for prediction of RDS mortality. Conclusions SNAPPE-Ⅱ and NCIS can be used to predict mortality risk of neonatal respiratory distress syndrome. The higher the SNAPPE-Ⅱ, the lower the NCIS, the higher the mortality risk of RDS. SNAPPE-Ⅱ is better in prediction of mortality risk of RDS, and can be more appropriate to assess the risk of death in neonates with RDS.