目的探讨早期预测高危新生儿罹患缺氧缺血性脑病(HIE)的风险率。方法选取2014年6月-2016年6月该院儿科存在高危因素的136例足月新生儿为样本进行分析,生后6 h内进行脑干听觉诱发电位(BAER)、振幅整合脑电图(aEEG)、闪光视觉诱发电位(FVEP)颅压监测、脐动脉血气分析、血神经组织蛋白质S-100B及头颅核磁共振成像(MRI)检查,比较其预测HIE发生的灵敏度、特异度、误诊率、漏诊率、阳性预测值、阴性预测值、总符合率及约登指数。结果脐动脉血p H检测灵敏度及阴性预测率最高,但特异度及漏诊率最低,头颅MRI及a EEG的特异度及阳性预测率最高,同时误诊率最低(均P<0.05);血神经组织蛋白质S-100B总符合率及约登指数最高(P<0.05)。结论血神经组织蛋白质S-100B早期预测HIE发生的意义最大,同时辅助进行脐动脉血H、头颅MRI、aEEG及FVEP检查,可早期发现并进行干预。 Objective To investigate the risk of early hypoxic-ischemic encephalopathy (HIE) in high-risk neonates. Methods A total of 136 full-term newborns with pediatric risk factors in pediatrics from June 2014 to June 2016 were selected for analysis. Brainstem auditory evoked potential (BAER) and amplitude-integrated electroencephalogram aEEG, intracranial pressure monitoring of flash visual evoked potential (FVEP), umbilical arterial blood gas analysis, S-100B and MRI were performed. The sensitivity, specificity, misdiagnosis rate, Misdiagnosis rate, positive predictive value, negative predictive value, total coincidence rate and Youden index. Results The sensitivity and negative predictive value of umbilical arterial blood p H were the highest, but the specificity and missed diagnosis were the lowest. The specificity and positive predictive value of cranial MRI and a EEG were the highest while the misdiagnosis rates were the lowest (all P <0.05) The overall coincidence rate of protein S-100B and the Youden index were the highest (P <0.05). Conclusion The early prediction of HIE occurs in S-100B, which is of great significance in the early stage. It also can assist in the examination of umbilical arterial blood H, head MRI, aEEG and FVEP and early detection and intervention.