摘要
目的探讨振幅整合脑电图在预测足月新生儿高胆红素血症早期脑损伤及预后中的应用价值。方法选取2013年1月至2014年8月我院新生儿科收治的48例高胆红素血症足月新生儿为研究对象(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,并征得受试对象监护人的知情同意,与之签署临床研究知情同意书),根据头颅磁共振成像(MRI)结果将其分为亚临床胆红素脑病组、高胆红素血症正常对照组;选择同期本院产科24例健康足月新生儿为健康对照组。比较三组患儿血清未结合胆红素(UCB)水平及脑干听觉诱发电位(BAEP)、振幅整合脑电图(a EEG)异常率,分析之间相关性;并跟踪随访,检测精神运动发育商(DQ)值并复查a EEG。结果 (1)亚临床胆红素脑病组、高胆红素血症正常对照组及健康对照组新生儿血清UCB水平、BAEP及a EEG异常率比较差异均有统计学意义(P<0.01)。亚临床胆红素脑病组血清UCB值、BAEP及a EEG异常率均高于高胆红素血症正常对照组及健康对照组,差异均有统计学意义(P<0.01);高胆红素血症正常对照组血清UCB水平虽显著高于健康对照组(P<0.01),但BAEP及a EEG异常率与健康对照组比较,差异无统计学意义(P>0.05)。(2)亚临床胆红素脑病组a EEG轻度异常13例中BAEP轻度异常5例,中度异常7例,重度异常1例;a EEG重度异常8例中BAEP重、极重度异常8例。a EEG与BAEP异常程度存在正相关(r=0.815,P=0.034)。(3)随访1年,失访重度a EEG异常1例。早期13例轻度a EEG异常者仅3例轻度异常(23.08%),10例a EEG正常,2例DQ值异常(15.38%),无一例后遗症发生;7例a EEG重度异常者仍全部异常(100%),其中2例轻度异常,5例仍重度异常,6例DQ值异常(85.71%),3例存在不同程度的后遗症。两组a EEG及DQ异常率比较差异均有统计学意义(P<0.05,P<0.01)。结论 a EEG可作为预测足月新生儿高胆红素血症早期脑损伤及
Objective To investigate the application value of amplitude integrated electroencephalogram （aEEG） in the prediction on early brain damage and prognosis for full-term neonates with hyperbilirubinemia. Methods From January 2013 to August 2014, 48 full-term neonates with hyperbilirubinemia were divided into two groups： subclinical bilirubin encephalopathy group and hyperbilirubinemia control group according to the results of magnetic resonance imaging （MRI）, while 24 normal healthy full-term infants born in our hospital at the same time were chosen as normal control group. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Clinic Medical College of Yangzhou University. Informed consent was obtained from each parents. The serum level of unconjugated bilirubin （UCB） and the abnormality rate for brainstem auditory evoked potential （BAEP） and aEEG were compared among three groups, meanwhile the correlation for these parameters were assayed. Developmental Ouotient （DQ） checking and aEEG reexamination were performed after 1 year. Results （1） There were significant differences in the level of UCB and the abnormality rate of BAEP and aEEG among different groups （P〈0.01）. The level of UCB, abnormality rate of BAEP and aEEG in subclinical bilirubin encephalopathy group were higher than those of the other 2 groups （P〈0.01）. The level of serum UCB were higher in hyperbilirubinemia control group than that in the normal control group, but there were no statistically significant differences for the abnormality rate of BAEP and aEEG. （2） Of the 13 mildly abnormal aEEG cases in the subclinical bilirubin encephalopathy group, 5 mildly abnormal, 7 moderately abnormal and 1 severely abnormal were found in BAEP test. All of the 8 severely abnormal aEEG cases in the subclinical bilirubin encephalopathy group were found severely/very severely abnormal of BAEP. By linear correlation analysis, the abnormality degree of aEEG was positively correlation with
出处
《中华临床医师杂志（电子版）》
CAS
2016年第5期650-655,共6页
Chinese Journal of Clinicians(Electronic Edition)
关键词
婴儿
新生
高胆红素血症
脑损伤
预后
振幅整合脑电图
Infant,newborn
Hyperbilirubinemia
Brain injuries
Prognosis
Amplitude integrated electroencephalogram
