经皮血氧饱和度筛查新生儿先天性心脏病监测时间段分析

目的探讨经皮血氧饱和度(POX)筛查新生儿先天性心脏病(CHD)的最佳监测时间段。方法选择符合研究标准的新生儿5 433例,在出生后的~24 h、~48 h、~72 h三个时间段分别行POX测定,以彩色超声心动图检查结果为甄别CHD的金标准,评估POX监测CHD在各个时间段的灵敏度、特异度、假阳性率、假阴性率等。结果 ~24 h、~48 h、~72 h三个时间段分别行POX测定,灵敏度为54.72%~67.92%,特异度为99.11%~99.61%,假阴性率为32.08%~43.40%,假阳性率为0.39%~0.89%,约登指数为0.54~0.68;符合率为98.67~99.30及kappa值为0.44~0.65。结论在新生儿CHD筛查过程中出生后的48~72 h检测POX,灵敏度、特异度最高,假阴性率及假阳性率最低,符合率及kappa值最大,最真实、可靠。具有一定的临床应用价值。

Analysis of intervals of pulse oximetry in congenital heart disease screening

Objective To explore the best time period of pulse oximetry in congenital heart disease (CHD) screening. Methods Totally 5433 newborns delivered or treated in Ningbo Women and Children’s hospital were enrolled in the study. Cardiac color ultrasound was used to arrive diagnosis and every screening time period (0?~?24 h、24 h?~?48 h、48 h?~?72 h) was analysed. Results Among the three time periods: the sensibility was in the range of 54.72%?~?67.92%, specificity was 99.11%?~?99.61%, false negative rate was 32.08%?~?43.40%, false positive rate was 0.39%?~?0.89%, Youden index was 0.54?~?0.68, coincidence rate was 98.67?~?99.30, and kappa was 0.44?~?0.65. Conclusion The best screening time is the period between 48h and 72 h after birth.