早期振幅整合脑电图对极低出生体重儿脑损伤的预测价值

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摘要目的探讨极低出生体重儿（VLBW）早期振幅整合脑电图（aEEG）对脑损伤的预测价值。方法回顾性选择2017年8月至2019年8月深圳市人民医院新生儿科收治的VLBW77 例作为研究对象，将住院期间诊断脑损伤的30 例患儿作为试验组，住院期间无脑损伤的47 例患儿作为对照组。比较两组患儿连续性电压（CV）、不连续性电压（DV）、睡眠-觉醒周期（SWC）、惊厥（EA）发作的情况。用ROC 曲线评价CV、DV 比例及SWC 评分对脑损伤的预测价值。结果试验组aEEG 中DV、EA 发生率高于对照组，差异有统计学意义（P<0.05）。试验组aEEG 中CV、SWC 评分低于对照组，差异有统计学意义（P<0.05）。试验组EA 例数多余对照组，差异有统计学意义（P<0.05）。重度脑损伤组中出现爆发-抑制（BS）的例数高于轻度脑损伤组，差异有统计学意义（P<0.05）。重度脑损伤组出现SWC 的例数少于轻度脑损伤组，差异有统计学意义（P<0.05）。ROC 曲线评价CV、DV 比例及SWC 评分对VLBW脑损伤的预测价值，曲线下面积（AUC）分别为0.783、0.809、0.756。结论 VLBW 发生脑损伤时，其出生后24 h 内的aEEG 中CV 比例较低，DV 比较较高，SWC 评分较低。CV、DV 的比例及SWC 评分可以预测VLBW 有无脑损伤，其中DV 比例预测价值最高。

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	易晓利
	秦云
	涂惠英
	谭军

关键词 ：极低出生体重儿, 脑损伤, 振幅整合脑电图, 新生儿

Abstract：Objective To explore the predictive value of early amplitude integrated electroencephalogram(aEEG)for brain injury in very low birth weight (VLBW) infants. Methods Seventy-seven cases of VLBW admitted to the Neonatology Department of Shenzhen People′s Hospital from August 2017 to August 2019 were retrospectively selected as the research subjects, a total of 30 children with brain injury diagnosed during hospitalization were selected as the experimental group, and 47 patients without brain injury during hospitalization were selected. children as a control group. The continuous voltage (CV), discontinuous voltage (DV), sleep-wake cycle (SWC) and eclampsia (EA) were compared between the two groups. The predictive value of CV, DV ratio and SWC score for brain injury were evaluated by ROC curves. Results The incidence of DV and EA in aEEG of the experimental group were higher than those of the control group, and the differences were statistically significant (P<0.05). The CV and SWC scores in aEEG of the experimental group were lower than those of the control group, and the differences were statistically significant (P<0.05). The number of EA cases in the experimental group was more than that in the control group, and the difference was statistically significant (P<0.05).The number of burst-suppression (BS) cases in the severe brain injury group was higher than that in the mild brain injury group, and the difference was statistically significant (P<0.05). The number of SWC cases in the severe brain injury group was less than that in the mild brain injury group, and the difference was statistically significant (P<0.05).The ROC curve evaluated the predictive value of CV, DV ratio and SWC score on VLBW brain injury,and the areas under the curve (AUC) were 0.783, 0.809 and 0.756, respectively. Conclusion When VLBW developed brain injury, its CV score was lower, its score was higher for DV and lower for SWC in aEEG within 24 h after birth.The scores of CV, DV, and SWC can predict the brain impairment of VLBW, of which the DV score has the highest predictive value.

Key words： Very low birth weight infants Brain damage Amplitude-integrated electroencephalogram Neonatal

引用本文:

易晓利；秦云；涂惠英；谭军. 早期振幅整合脑电图对极低出生体重儿脑损伤的预测价值[J]. 中国当代医药, 2022, 29(6): 73-76.
YI Xiaoli；QIN Yun；TU Huiying；TAN Jun. Predictive value of early amplitude integrated electroencephalogram for brain injury in very low birth weight infants. 中国当代医药, 2022, 29(6): 73-76.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I6/73

[1]	宋磊，蒋文.振幅整合脑电图与磁敏感加权成像在早产儿脑损伤诊断中的运用[J].中国医师杂志，2020，22（2）：269-272.
[2]	沈佩婷，黄金华，温晓红，等.振幅整合脑电图对早产儿脑白质损伤的早期诊断及近期神经发育预后评估的应用价值[J].中国妇幼保健，2019，34（4）：222-225.
[3]	Buchiboyina A，Yip CSA，Madhala S，et al.Incidental Findings on Brain Magnetic Resonance Imaging in Preterm Infants[J].Neonatology，2019，115（1）：1-4.
[4]	Bruns N，Dransfeld F，Hüning B，et al.Comparison of two common aEEG classifications for the prediction of neurodevelopmental outcome in preterm infants[J].Eur J Pediatr，2017，176（2）：163-171.
[5]	Olischar M，Klebermass K，Kuhle S，et al.Reference values for amplitude-integrated electroencephalographic activity in preterm infants younger than 30 weeks′ gestational age[J].Pediatrics，2004，113（1）：e61-e66.
[6]	Burdjalov VF，Baumgart S，Spitzer AR.Cerebral function monitoring：a new scoring system for the evaluation of brain maturation in neonates[J].Pediatrics，2003，112（4）：855-861.
[7]	刘志勇，王瑞泉，吴联强，等.振幅整合脑电图在胎龄小于30 周早产儿脑功能监测中的意义[J].中国小儿急救医学，2019，26（6）：441-446.
[8]	Zhu X，Guo Y，Liu Y，et al.Amplitude-Integrated Electroencephalography for Early Diagnosis and Prognostic Prediction of Hypoxic Encephalopathy in Preterm Infants[J].Med Sci Monit，2018，24：8795-8802.
[9]	刘慧苹，蒋峰原，宋忠瑞，等.振幅整合脑电图评分、血清血红素氧化酶-1 水平对早产儿脑损伤的早期预测价值[J].检验医学与临床，2020，17（22）：3256-3259.
[10]	Han YM，Lee NR，Bae MH，et al.Establishing reference values for amplitude-integrated electroencephalography in preterms below 35 weeks of gestational age：A prospective observational cohort study[J].Turk J Pediatr，2016，58（6）：592-601.
[11]	薛辛东，于灏婷.振幅整合脑电图在早产儿中的临床应用进展[J].中华实用儿科临床杂志，2018，33（14）：1052-1056.
[12]	丛晓亚，申飞飞，索桂海，等.早产儿脑损伤早期诊断方法评价[J].交通医学，2019，33（6）：638-640.
[13]	任雪军.脑电图监测在判断早产儿早期脑功能中的临床价值[J].检验医学与临床，2015，12（23）：3487-3488.
[14]	杨磊，徐巍，严超英.早产儿颅内出血振幅整合脑电图背景模式及睡眠觉醒周期的特点[J].中国当代儿科杂志，2016，18（10）：965-970.
[15]	梁玉美，黎诗娜，李兆杭.振幅整合脑电图在晚期早产儿脑损伤早期诊断及预后评估中的应用价值[J].中国医药科学，2021，11（6）：83-86，96.
[16]	Meledin I，Tzur-Sebton H，Noyman I，et al.Seizures in Premature Infants Born at Less than 28 Weeks′ Gestation[J].Neonatology，2019，115（3）：247-255.
[17]	Ralser E，Neubauer V，Peglow UP，et al.Amplitude-integrated electroencephalography can predict neurodevelopmental outcome at 12 months of corrected age in very preterm infants[J].Acta Paediatr，2017，106（4）：594-600.
[18]	Topcuoglu S，Kolsuz LD，Gursoy T，et al.Effects of preeclampsia on the amplitude integrated electroencephalography activity in preterm infants[J].J Perinat Med，2016，44（3）：345-349.
[19]	Feldmann M，Rousson V，Nguyen TD，et al.Cognitive outcome of early school-aged children born very preterm is not predicted by early short-term amplitude-integrated electroencephalography[J].Acta Paediatr，2020，109（1）：78-84.
[20]	Midde RGl，Brandenbarg N，Van Braeckel KNJA，et al.The Predictive Value of Amplitude-Integrated Electroencephalography in Preterm Infants for IQ and Other Neuropsychological Outcomes at Early School Age[J].Neonatology，2018，113（4）：287-295.
[21]	De Castro JS，Leslie ATFS，Guinsburg R.Perinatal factors associated with amplitude-integrated electroencephalography abnormalities in preterm infants on the first day of life[J].J Pediatr，2020，96（5）：644-651.