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目的:探讨新生儿行为神经测查(NBNA20项)在29～45天婴儿的应用价值。方法;选取2009年1月1日～12月31日在该院产科出生、儿保科门诊随访满45天的婴儿为研究对象,采用现况调查的方法,分别对其进行NBNA测查和《0～6岁小儿神经心理发育量表(2005版)》评估。结果:调查婴儿1 287名,其中男婴694名,女婴593名,以29天～和42～45天为主(37.30%和38.00%),地域分布以江岸区、江汉区居多(46.08%、20.98%),测查时间以第三、四季度为主(31.08%和30.69%)。NBNA总分在34～40分之间,中位数40分,合格者1 282例(99.61%),低下者5例(0.39%);神经心理发育评估总分在29～162分之间,中位数95分,总体发育商低下30例(2.33%),正常、聪明及优秀者1 066例(82.83%)。NBNA20项对29～45天婴儿的神经心理发育落后评估的灵敏度为6.67%,特异度为99.76%,正确指数为6.43%,Kappa指数0.08;对神经心理发育正常的灵敏度为99.91%,特异度为1.81%,正确指数为1.72%,Kappa指数0.03。结论:NBNA20项不适用于29～45天婴儿的神经发育落后及正常的评估。
Objective: To investigate the value of neonatal behavioral neurological assessment (NBNA20) in infants aged 29-45 days. Methods; selected from January 1, 2009 to December 31, 2009 in the hospital obstetrics and gynecology births, babies over 45 days of follow-up of infants as the research object, using the current situation survey method, respectively NBNA test and “0 ~ 6-year-old children neuropsychological development scale (2005 version) ”assessment. Results: A total of 1 287 infants were investigated, of whom 694 were male infants and 593 were female infants, with a predominance of 29 days and 42-45 days (37.30% and 38.00%). The geographical distribution was mainly in Jiang’an District and Jianghan District (46.08% , 20.98%), the third and fourth quarter of the test time (31.08% and 30.69%). The total score of NBNA was between 34 and 40, the median was 40, and 1 282 (99.61%) were eligible and 5 (0.39%) were low. The score of neuropsychological assessment was between 29 and 162, Median 95 points, 30 cases of low overall growth rate (2.33%), 1 066 cases (82.83%) of normal, smart and excellent. NBNA20 items had a sensitivity of 6.67%, a specificity of 99.76%, a correct index of 6.43% and a Kappa index of 0.08 for neuropsychological developmental decline in infants aged 29-45 days. The sensitivity to neuropsychological development was 99.91% with a specificity of 1.81%, the correct index was 1.72% and the Kappa index was 0.03. CONCLUSIONS: The NBNA 20 item is not applicable to the neurodevelopmental and normal assessment of infants aged 29-45 days.