摘要
目的:探讨振幅整合脑电图(Amplitude-integrated electroencephalography,aEEG)评分与新生儿高胆红素血症(Hyperbilirubinemia,HBHB)脑损伤严重程度的相关性及其对HB患儿预后的预测价值,以期为临床早期制定相应治疗方案提供参考。方法:选取2021年6月~2023年6月周口市妇幼保健院收治的78例HB新生儿作研究对象的HB组,另选取同期78例健康新生儿作为研究对象的对照组,均进行aEEG检查。比较HB组与对照组及脑损伤不同严重程度HB患儿的aEEG评分(连续性、睡眠-觉醒周期、下边界振幅、波普带宽度与下边界振幅变化),分析aEEG评分与新生儿HB脑损伤严重程度的相关性。随访6 m后,根据Gesell发育测试量表评分将HB患儿分为预后良好组和预后不良组,比较不同预后患儿的aEEG评分,并分析aEEG评分对GHB患儿预后的预测价值。结果:HB组连续性、睡眠-觉醒周期、下边界振幅、波普带宽度与下边界振幅变化评分、总分均明显低于对照组(P<0.05);脑损伤不同严重程度HB患儿的连续性、睡眠-觉醒周期、下边界振幅、波普带宽度与下边界振幅变化评分、总分比较:轻度>中度>重度(P<0.05);HB脑损伤患儿连续性、睡眠-觉醒周期、下边界振幅、波普带宽度与下边界振幅变化评分、总分与脑损伤严重程度呈负相关(P<0.05);预后不良组连续性、睡眠-觉醒周期、下边界振幅、波普带宽度与下边界振幅变化评分及总分均低于预后良好组(P<0.05);aEEG总分预测HB患儿预后的AUC为0.927,高于连续性、睡眠-觉醒周期、下边界振幅、波普带宽度与下边界振幅变化等单项预测的AUC 0.765、0.784、0.813、0.812(P<0.05)。结论:aEEG评分可用于评估新生儿HB脑损伤严重程度,且对HB患儿的预后就要较高的预测价值,可为临床早期预测预后提供参考依据,有助于针对性展开后续治疗,改善HB患儿的预后。
Objective:To investigate the relationship of amplitude-integrated electroencephalography(aEEG)scores with the severity of neonatal hyperbilirubinemia(HB)brain injury,and its predictive value for the prognosis of HB.Methods:Seven-eight cases of HB newborn admitted to Zhoukou Maternal and Child Health Hospital from June 2021 to June 2023 were selected as HB group,and 78 healthy newborn during the same period were selected as control group.aEEG examination was performed.The aEEG scores(continuity,sleep-wake cycle,amplitude of lower boundary,width of pop band and amplitude of lower boundary)of HB patients with different severity of brain injury were compared between HB group and control group,and the correlation of aEEG scores with the severity of HB brain injury newborn was analyzed.After 6 months of follow-up,children with HB were divided into good prognosis group and poor prognosis group according to Gesell developmental test scale score.aEEG scores of HB with different prognosis were compared,and the predictive value of aEEG scores on the prognosis of HB was analyzed.Results:The score of continuity,sleep-wake cycle,lower boundary amplitude,pop band width and lower boundary amplitude change and total score in HB group were lower than those in control group(P<0.05).The continuity,sleep-wake cycle,lower boundary amplitude,pop band width and lower boundary amplitude change score and total score of HB with different severity of brain injury were compared:mild>moderate>severe,and the difference was statistically significant(P<0.05).The continuity,sleep-wake cycle,lower boundary amplitude,pop band width and lower boundary amplitude change score,total score were negatively correlated with the severity of brain injury in HB(P<0.05).Continuity,sleep-wake cycle,lower boundary amplitude,pop band width and lower boundary amplitude change scores and total scores of the poor prognosis group were lower than those of the good prognosis group(P<0.05).The AUC of the total aEEG scores predicting the prognosis of HB children was 0.92
作者
胡双双
赵一品
周霞
徐向峰
Hu Shuang-shuang;Zhao Yi-pin;Zhou Xia;Xu Xiang-feng(Neonatal Intensive Care Unit,Zhoukou Maternal and Child Health Hospital,Zhoukou 466000,Henan,China)
出处
《四川生理科学杂志》
2024年第6期1211-1214,共4页
Sichuan Journal of Physiological Sciences
基金
河南省医学科技攻关联合共建项目(LHGJ20221017)。
关键词
振幅整合脑电图
新生儿
高胆红素血症
脑损伤
预后
Amplitude-integrated electroencephalography
Newborn
Hyperbilirubinemia
Brain injury
Prognosis
