振幅整合脑电图结合斯堪的那维亚卒中量表在急性脑梗死患者中的预测价

Predictive value of amplitude integration with electroencephalogram combined with the Scandinavian Stroke Scale in patients with acute cerebral infarction

目的研究振幅整合脑电图(aEEG)结合斯堪的那维亚卒中量表(SSS)对急性梗死预后评估价值。方法选取本院2019年2月-2021年7月收治的124例急性脑梗死患者为研究对象,入院后检测患者振幅整合脑电图和SSS评分,28 d后采用日常生活能力评定量表(Barthel指数)评估患者预后,根据评分分为预后良好组(Barthel指数评分>45分)和预后不良组(Barthel指数评分≤45分)。Logistic回归分析影响患者预后不良的危险因素。绘制受试者工作特征(ROC)曲线,分析aEEG、SSS评分对患者预后不良的预测价值。结果预后不良组入院时aEEG上下边界、SSS评分水平、入院时GCS评分低于预后良好组(P<0.05),脑疝形成、多器官功能衰竭占比,hs-CRP、D-D水平高于预后良好组(P<0.05)。Logistic回归分析显示,aEEG上下界水平、脑疝形成、多器官功能衰竭、入院时SSS评分、入院时GCS评分均是患者预后不良的危险因素(P<0.05)。ROC曲线分析显示,入院时aEEG上下边界与SSS评分三者联合预测急性脑梗死患者预后不良的灵敏度、准确度、AUC分别为92.35%、89.57%、0.829。结论aEEG、SSS评分是急性脑梗死患者预后不良的独立危险因素,二者结合对急性脑梗死预后具有较高的预测价值。

Objective To study the value of amplitude integrated electroencephalogram(aEEG)combined with the Scandinavian Stroke Scale(SSS)in evaluating the prognosis of acute infarction.Methods One hundred and twenty-four patients with acute cerebral infarction admitted to our hospital from February 2019 to July 2021 were selected as the research objects.After admission,the amplitude integrated EEG and SSS scores were measured.After 28 days,the prognosis of the patients was assessed by the activity of daily living scale(Barthel Index).According to the scores,the patients were divided into the good prognosis group(Barthel index score>45)and the poor prognosis group(Barthel index score≤45).Logistic regression analysis was used to analyze the risk factors of poor prognosis.Draw the receiver operating characteristic(ROC)curve,and analyze the predictive value of AEEG and SSS scores for poor prognosis.Results The AEEG upper and lower boundaries,SSS score and GCS score in the poor prognosis group were lower than those in the good prognosis group(P<0.05),the proportion of brain hernia formation and multiple organ failure,and the levels of hs CRP and D-D in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Logistic regression analysis showed that AEEG upper and lower bounds,brain hernia formation,multiple organ failure,SSS score at admission and GCS score at admission were all risk factors for poor prognosis(P<0.05).ROC curve analysis showed that the sensitivity,accuracy and AUC of aEEG upper and lower boundaries combined with SSS score in predicting poor prognosis of patients with acute cerebral infarction at admission were 92.35%,89.57%and 0.829 respectively.Conclusion aEEG and SSS scores are independent risk factors for poor prognosis in patients with acute cerebral infarction,and the combination of the two has a high predictive value for the prognosis of acute cerebral infarction.