Discussion Of The Value Of Amplitude Integrated EEG Combined With B/A Ratio And BIND Score For The Diagnosis Of Acute Bilirubin Encephalopathy

Objective:To explore the high risk factors of neonatal acute bilirubin encephalopathy,analyze the relationship between a EEG,B / A value and BIND score and acute bilirubin encephalopathy,evaluate the predictive value of a EEG,B / A value and BIND score for acute bilirubin encephalopathy,provide evaluation means for early diagnosis of clinical acute bilirubin encephalopathy,and provide evidence-based basis for clinical intervention.Methods:The clinical data of children with severe hyperbilirubinemia in Jiangxi Children’s Hospital from January 2015 to December 2020 were retrospectively collected.For 511 children who met the inclusion criteria,they were divided into ABE group(250 cases)(261 cases);general clinical data,etiology data of severe hyperbilirubinemia,peak TSB value,B / A value,B and I N D score,etc.Multivariate regression analysis was performed on statistically significant univariates.The consistency of a EEG with B / A values and BIND score in children with acute bilirubin encephalopathy was analyzed.Subject working curves were applied to analyze the predictive value of a EEG,B / A values,and BIND score.Results:1.Among the 11 cases of severe hyperbilirubinemia,homogeneous immune hemolysis accounted for 44.22%,the most common,and the highest proportion was ABO incompatibility(40.31%).2.Univariate analysis showed that the birth weight and uterine birth rate in the ABE group were lower than those in the non-ABE group(P <0.05),Day of age,peak TSB,high B / A,and high BIND scores were all significantly higher than those of the non-ABE group,There were statistical differences(all P <0.05),Multivariate Logistic regression analysis identified low birth weight(OR=1.001,CI 1.000-1.002),high peak TSB value(OR=1.009,CI 1.006-1.01012),high B / A values(OR=1.193,CI 1.003-1.440)and high BIND score(OR=1.718,CI 1.295-2.278)as independent risk factors for acute bilirubin encephalopathy.3.In the correlation consistency analysis,a EEG abnormality was associated with bilirubin encephalopathy(Kappa=0.624,P<0.05),compared with a EEG abnormality and BIND score(Kappa=0.486,P<0.05)and with B/A ratio(Kappa=0.540,P<0.05).4.The area under the curve of B/A ratio,BIND score,a EEG monitoring and the three methods were 0.736,0.814,0.806,and 0.869,respectively,as observed in the ROC curve of the three methods.5.At the optimal cut-off value,a EEG monitoring,B/A ratio,BIND score and the corresponding sensitivity and specificity are a EEG monitoring(sensitivity 68.3%,specificity 92.9%),B/A ratio 5.8(sensitivity 63.6%,specificity 78.2%),BIND score3.5(sensitivity 78%,specificity 87.6%),and the combination(sensitivity 68.9%,specificity 96.8%).Conclusions:1.Low birth weight,peak TSB,B / A value,and high BIND score were found to be risk factors for the occurrence of acute bilirubin encephalopathy.2.The a EEG abnormalities showed good agreement with B / A values and BIND scores in the diagosis of ABE.3.The combination of B / A value,BIND score and a EEG play an important role in the diagnosis of acute bilirubin encephalopathy.