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目的探讨振幅整合脑电图(a EEG)监测在早产儿脑损伤早期诊断中的应用价值及相关影响因素。方法选取2015年1月-2016年11月在杭州市儿童医院产科出生并收住于新生儿科的56例脑损伤早产儿为观察组,另选取同期在该院出生的48例无脑损伤健康早产儿为对照组。比较两组早产儿出生后6 h a EEG监测的a EEG图形连续性(Co)、睡眠觉醒周期(Cy)及下边缘振幅值(LB)评分均值情况;分析Co、Cy及LB评分对早产儿脑损伤的早期诊断价值及影响早产儿脑损伤的相关危险因素。结果观察组a EEG监测的Co、Cy及LB评分均显著低于对照组,差异有统计学意义(P<0.05);ROC曲线分析显示,Cy评分对早产儿脑损伤诊断的灵敏度为78.42%,特异度为70.59%,诊断价值高于Co、LB评分,同时Co、Cy及LB评分联合对早产儿脑损伤诊断的灵敏度为85.71%,特异度为81.25%,诊断价值更高;运用Logistic多因素逐步回归分析发现,脐带异常、母亲妊娠期高血压疾病是造成早产儿脑损伤的相关危险因素(P<0.05)。结论 a EEG监测可有效反映出早产儿脑功能的改变,且操作简便、图形直观,对于早产儿脑损伤的早期诊断具有重要价值,同时也要加强早产儿脑损伤危险因素的防治。
Objective To investigate the value of amplitude-integrated electroencephalogram (EEG) monitoring in early diagnosis of brain injury in preterm infants and its related factors. Methods From January 2015 to November 2016, 56 children with brain injury born in obstetrics and gynecology department of Hangzhou Children’s Hospital and admitted to neonatology department were selected as observation group. Another 48 preterm births without brain injury Children as control group. The EEG pattern continuity (Co), sleep awakening cycle (Cy) and lower edge amplitude (LB) score of 6-h EEG monitoring were compared between the two groups. The changes of Co, Cy and LB scores in preterm infants Early diagnosis of injury and related risk factors affecting brain injury in preterm infants. Results The scores of Co, Cy and LB in observation group a EEG were significantly lower than those in control group (P <0.05). The ROC curve analysis showed that Cy sensitivity was 78.42% in the diagnosis of brain injury in preterm infants, The specificity was 70.59%. The diagnostic value was higher than that of Co and LB. The sensitivity, specificity and accuracy of the combination of Co, Cy and LB scores for the diagnosis of brain injury in premature infants were 85.71% and 81.25%, respectively. Stepwise regression analysis showed that umbilical cord abnormalities and maternal hypertensive disorder complicating pregnancy were the risk factors of brain injury in preterm infants (P <0.05). Conclusion EEG monitoring can effectively reflect the changes of brain function in preterm infants, and it is easy to operate and intuitive in graphics. It is of great value in the early diagnosis of brain injury in premature infants and prevention and treatment of risk factors of brain injury in premature infants.