摘要目的:探究中文版Hammersmith新生儿神经学检查(C-HNNE)量表的信度与效度。方法:前瞻性队列研究。选取2022年10月至2023年8月在深圳市龙岗区妇幼保健院出生，出生后于新生儿科和产科住院，符合纳入标准的114例新生儿作为研究对象，按不同出生胎龄分为早期早产儿组(34例)、中晚期早产儿组(50例)、足月儿组(30例)。于出生24 h内完善首次C-HNNE评估，并从3组中各自抽取20例进行评分者信度检测；首次C-HNNE评估48 h后，各组随机抽取20例再次完善C-HNNE评估，用于重测信度检测；矫正4月龄时由儿童康复科医师通过临床检查结合全身运动(GMs)评估判断其短期神经发育结局。通过计算组内相关系数(ICC)检测评分者信度与重测信度，通过绘制受试者工作特征(ROC)曲线确立C-HNNE在各组的最优分数，通过计算灵敏度、特异度、阳性预测值(PPV)和阴性预测值(NPV)确定预测效度。结果:早期早产儿组、中晚期早产儿组与足月儿组C-HNNE最优分数分别取22.25、25.25、29.25分时，其预测新生儿矫正4月龄神经运动发育结局的敏感性最高。3组C-HNNE总分及各子量表的评分者ICC均在0.7以上，评分者信度较好；C-HNNE中部分条目重测ICC<0.6，重测信度一般。效度方面，3组C-HNNE总分与GMs评分的相关系数分别为0.550、0.483、0.473(均 P<0.01)，C-HNNE预测新生儿矫正4月龄神经发育结局的敏感度为82.9%，特异度为70.4%，PPV为58.0%，NPV为89.3%。 结论:C-HNNE量表的信度和效度良好，可作为新生儿早期床旁常规检查项目使用。

abstractsObjective:To explore the reliability and validity of the Chinese version of Hammersmith Neonatal Neurological Examination (C-HNNE).Methods:A prospective cohort study.One hundred and fourteen neonates born in Longgang District Maternity & Child Healthcare Hospital of Shenzhen City between October 2022 and August 2023, who were hospitalized in the Neonatology or Obstetrics Department after birth and met the inclusion criteria, were enrolled as study subjects.They were divided into an early preterm group(34 cases), a mid-late preterm group(50 cases), and a full-term group(30 cases) based on gestational age.The first C-HNNE assessment was completed within 24 hours after birth, and 20 cases from each group were selected for inter-rater reliability assessment; 48 hours after the first C-HNNE assessment, 20 cases from each group were selected to undergo the C-HNNE assessment again for test-retest reliability assessment.At corrected 4 months of age, short-term neurodevelopmental outcomes were determined by pediatric rehabilitation physicians using clinical examination combined with general movements (GMs) assessment.Inter-rater reliability and test-retest reliability were assessed by calculating intra-class correlation coefficient (ICC). The optimal cutoff scores of the C-HNNE for each group were determined by plotting receiver operating characteristic(ROC) curves.Predictive validity was determined by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results:The highest sensitivity for predicting neonatal corrected neuromotor developmental outcome at 4 months of age was achieved when the optimal C-HNNE scores were taken as 22.25, 25.25, and 29.25 in the early preterm, mid-late preterm, and term groups, respectively.The ICCs for the inter-rater reliability of the total C-HNNE score and subscale scores in all 3 groups were above 0.7, indicating good reliability.The ICCs for test-retest reliability of some individual items were<0.6, indicating moderate reliability.In terms of validity, the correlation coefficients between the total C-HNNE scores and the GMs scores of the three groups were 0.550, 0.483, 0.473 (all P<0.01), and the sensitivity of the C-HNNE for predicting neurodevelopmental developmental outcomes in neonates corrected to 4 months of age was 82.9%, specificity was 70.4%, PPV was 58.0%, and NPV was 89.3%. Conclusions:C-HNNE demonstrates good reliability and validity and can be used as a routine bedside examination program for early neonatal life.