摘要
目的探讨脑电图(EEG)背景活动在早产儿脑损伤中的应用价值。方法选择2008年11月至2010年10月我院新生儿重症监护病房诊断为脑损伤的早产儿为病例组,分为轻度脑损伤组(包括脑室内出血Ⅰ级和Ⅱ级,脑室周围白质软化Ⅰ级和Ⅱ级)和重度脑损伤组(包括脑室内出血Ⅲ级和Ⅳ级,脑室周围白质软化Ⅲ级和Ⅳ级),同期选择无脑损伤的早产儿为对照组,各组早产儿均于生后3~28天进行EEG测试,比较各组脑电图结果以及脑损伤程度与EEG结果的相关性。结果重度脑损伤组(11例)和轻度脑损伤组(56例)最大背景抑制间期、非连续背景活动暴发间隔时间、交替性背景活动期最长暴发间隔时间和暴发段振幅均值、静态睡眠期持续慢波睡眠振幅、清醒期振幅等均高于对照组(93例),差异有统计学意义(P<0.05),且重度脑损伤组高于轻度脑损伤组(P<0.05)。生后4周内EEG异常程度与脑损伤程度正相关(r=0.727,P<0.05)。病例组随访53例,轻度脑损伤组EEG恢复率明显高于重度脑损伤组(88.4%比50.0%,P<0.05)。结论脑损伤程度越重的早产儿EEG背景改变越明显,脑电图背景活动应用于早产儿脑损伤,能客观评价脑功能发育状态。
Objective To study the clinical application value of Electroencephalographic (EEG) background in premature infants with brain injuries. Methods Totally 67 premature neonates with brain injuries admitted to our hospital NICU from Nov. 2008 to Oct. 2010 were enrolled. Patients were assigned into mild brain injury group [ ( grade I-II of intraventricular hemorrhage (IVH) or grade I - II of periventricular leukomalacia (PVL) ], and severe brain injury group ( grade III - IV of IVH, or grade III - IV of PVL). Premature neonates without brain injury were recruited in the control group. EEG testing was carried out at 3 - 28 days of chronological age. Correlation between the severity of brain injuries and the results of EEG were analyzed. Results Comparing to the 93 patients in the control group, the 67 patients with brain injuries (including 11 in severe group and 56 in mild group ) have prolonged Maximum Interburst Interval (IBI Max), Trace Discontinue (TD) outbreak interval, and the maximum interval of the Trace Alternant (TA) phase; Infants with brain injuries also have higher mean amplitude of the TA Outbreak phase, amplitude of Continue Slow-spike Wave Sleep (CSWS) during Quiet Sleep (QS) phase; and amplitude during the awakening phase (all P values 〈 0. 05 ). In addition, the degree of EEG abnormalities during neonatal period was positively related to the severity of brain injuries (r = 0. 727, P 〈 0. 05). Among 53 patients whom were followed up at 3 months of age, 88.4% of infants with mild brain injury and 50% infants with severe brain injury have recovered (P 〈0. 05). Conclusions The degree of EEG background changes has a positive correlation to the severity of brain insults in premature infants. EEG Background measurements may be used in clinical practice to evaluate the state of brain function objectively.
出处
《中国新生儿科杂志》
CAS
2012年第1期24-27,共4页
Chinese Journal of Neonatology
基金
广西柳州市科技局2009年科技攻关课题(2009021501)
关键词
脑损伤
脑电描记术
婴儿
早产
Brain injuries
Electroencephalography
Infants, premature