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目的探讨不同胎龄新生儿早期脑电图最大背景抑制间期(IBImax)的变化,评价其在新生儿脑损伤中的临床意义。方法选择深圳市人民医院120例不同胎龄的新生儿(其中无脑损伤者84例,脑损伤者36例),无脑损伤新生儿按胎龄分为:Ⅰ、Ⅱ、Ⅲ、Ⅳ组。脑损伤者分为足月儿缺氧缺血性脑病(HIE)组和早产儿脑损伤(PBL)组。根据胎龄分别选取无脑损伤的足月儿28例和早产儿20例作为脑损伤患儿的对照组。全部对象于生后3~5d以江苏伟思长程脑电图仪记录EEG,以IBImax为观察指标。结果(1)Ⅰ、Ⅱ、Ⅲ、Ⅳ组IBImax分别为(17.62±3.99)s、(10.70±2.58)s、(7.05±1.53)s、(4.00±1.79)s,四组比较,差异有统计学意义(P=0.000)。IBImax与胎龄负相关(r=-0.843,P值为0.000)。(2)HIE组与对照组IBImax分别为(14.15±5.09)s、(4.04±1.81)s,差异有统计学意义(P=0.000)。PBL组与对照组IBImax分别为(20.38±5.69)s、(13.00±5.82)s,差异有统计学意义(P=0.001)。结论脑电图IBImax与新生儿脑成熟度有关,是早期评价新生儿脑损伤的指标。
Objective To investigate the changes of the maximum background suppression interval (IBImax) in neonates with different gestational age at early stage and to evaluate their clinical significance in neonatal brain injury. Methods A total of 120 neonates with different gestational ages (including 84 without brain injury and 36 with brain injury) were selected from Shenzhen People’s Hospital. Neonates without brain injury were divided into groups Ⅰ, Ⅱ, Ⅲ and Ⅳ according to gestational age. Brain injury were divided into term infants with hypoxic-ischemic encephalopathy (HIE) group and premature infants with brain injury (PBL) group. According to gestational age were selected without brain injury in 28 cases of full-term children and 20 cases of premature children as a control group of children with brain injury. All subjects recorded EEG in Jiangsu Weisi Long-range EEG at 3 ~ 5 days after birth, and IBImax was used as the observation index. Results (1) The IBImax of group Ⅰ, Ⅱ, Ⅲ and Ⅳ were (17.62 ± 3.99) s, (10.70 ± 2.58) s and (7.05 ± 1.53) s and (4.00 ± 1.79) s respectively Significance (P = 0.000). IBImax was negatively correlated with gestational age (r = -0.843, P = 0.000). (2) The IBImax in HIE group and control group were (14.15 ± 5.09) s and (4.04 ± 1.81) s, respectively, with significant difference (P = 0.000). The IBImax of PBL group and control group were (20.38 ± 5.69) s and (13.00 ± 5.82) s, respectively, with significant difference (P = 0.001). Conclusions The IBImax of EEG is related to the brain maturity of neonates and is an index for early assessment of neonatal brain injury.