摘要
目的探讨早期振幅整合脑电图(aEEG)评分系统在晚期早产儿脑损伤中的临床价值。方法选取2021年1月至2023年10月杭州市第一人民医院新生儿重症监护室住院的胎龄>34周并存活出院的早产儿84例,于生后6 h内进行脑功能监测,采用aEEG评分系统分析早产儿在不同严重程度脑损伤下的aEEG图像及总评分差异。绘制受试者工作特征曲线,分析aEEG评分系统对早产儿中重度出血性脑损伤的诊断效能。结果头颅超声结果显示,84例早产儿中,正常对照组43例,轻度损伤组29例,中重度损伤组12例。三组连续性(Co)、睡眠觉醒周期(Cy)、下边界振幅(LB)、带宽与下边界振幅(B)和总评分(T)比较,差异有统计学意义(P<0.05)。中重度损伤组Co、Cy、LB、Cy、B、T均低于正常对照组及轻度损伤组(P<0.05)。轻度损伤组Cy低于正常对照组(P<0.05)。联合诊断的灵敏度及AUC高于单一指标,T的灵敏度及AUC高于其他单一指标,Co的特异度最高(P<0.05)。结论aEEG评分系统在晚期早产儿脑损伤中的临床价值较高,Co、Cy、LB、Cy、B及T联合使用具有较高的诊断价值。
Objective To investigate the clinical value of early amplitude-integrated electroencephalography(aEEG)scoring system in late preterm infants with brain injury.Methods A total of 84 preterm infants with gestational age>34 weeks admitted to the Neonatal Intensive Care Unit of Hangzhou First People’s Hospital from January 2021 to October 2023 who survived discharge were selected.Brain function monitoring was performed within 6 hours after birth.The aEEG scoring system was used to analyze the differences of aEEG images and total scores of preterm infants with different severity of brain injury.The receiver operating characteristic curve of subjects was drawn to analyze the diagnostic efficiency of aEEG scoring system for moderate and severe hemorrhagic brain injury in preterm infants.Results Skull ultrasound results showed that among the 84 preterm infants,43 cases were normal control group,29 cases were mild injury group and 12 cases were moderate and severe injury group.Continuity(Co),sleep-wake cycle(Cy),amplitude of the lower bordere(LB),bandwidth and lower boundary amplitude(B)and total score(T)were compared among the three groups,and the differences were statistically significant(P<0.05).Co,Cy,LB,Cy,B,T in moderate and severe injury group were lower than those in normal control group and mild injury group(P<0.05).Cy in mild injury group was lower than that in normal control group(P<0.05).The sensitivity and area under the curve of combined diagnosis were higher than those of single index,the sensitivity and area under the curve of T were higher than those of other single index,and the specificity of Co was the highest(P<0.05).Conclusion The aEEG scoring system has high clinical value in the diagnosis of brain injury in late preterm infants,and the combined use of Co,Cy,LB,Cy,B and T has high diagnostic value.
作者
贾新慧
卢燕
娄新睿
胡雯霞
张志群
JIA Xinhui;LU Yan;LOU Xinrui;HU Wenxia;ZHANG Zhiqun(The Fourth Clinical School,Zhejiang Chinese Medical Univers ity,Zhejiang Province,Hangzhou 310053,China;Department of Neonatology,Hangzhou First People’s Hospital,Zhejiang Province,Hangzhou 310006,China;Department of Neonatology,Sir Run Run Shaw Hospital,Zhejiang Province,Hangzhou 310020,China;The Second Clinical School,Zhejiang Chinese Medical University,Zhejiang Province,Hangzhou 310053,China)
出处
《妇儿健康导刊》
2024年第9期189-193,共5页
JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE
基金
浙江省杭州市生物医药和健康产业发展扶持科技专项(2021WJCY266)。
关键词
振幅整合脑电图
晚期早产儿
脑损伤
诊断
Amplitude-integrated electroencephalography
Late preterm infant
Brain injury
Diagnosis
