脑电图反应性定量分析对重症脑血管病预后评估的研究

Study on quantitative electroencephalographic reactivity in the assessment of prognosis for critical cerebral vascular disease

目的:对急性脑血管病昏迷病人脑电图(EEG)反应性进行目测和定量分析,探讨定量分析是否较目测分析能更准确地评估预后。方法:56例急性脑血管病昏迷病人在入院、入院1周、出院时分别作EEG检查。采用目测和定量分析EEG反应性,观察EEG的变化及外源性刺激引起的绝对功率变化百分比。结果:EEG反应性目测分析:EEG反应性阳性病例组格拉斯哥昏迷量表(GCS)评分增加病例的比例高于反应性阴性病例组。EEG反应性定量分析:EEG各频段绝对功率变化百分比在GCS评分增加的病例组显著高于GCS评分减少的病例组;EEG各频段绝对功率变化百分比与GCS评分呈显著正相关。绝对功率变化百分比及EEG反应性目测结果与GCS评分都有线形回归关系,绝对功率变化的百分比对GCS评分的回归作用较目测反应性大。结论:EEG反应性目测分析和定量分析都能评估脑血管病昏迷病人的预后;EEG反应性定量分析较目测分析与预后关系更密切,能更准确评估预后。

Objective： To assess EEG reactivity of the patients with acute cerebrovascular disease （CVD） and determine whether quantitative analysis of reactivity possesses more accuracy than visula analysis of reactivity. Methods： Quantitative EEGs were determined in 56 acute CVD coma patients at the time of admission,a week after admission and at the time of discharging. Visual analysis of reactivity and external stimulus-reduced percentage of absolute power changes were observed. Results：Visual analysis： h was significant difference between reactivity and none reactivity in outcome of patients. Quantitative analysis：There was significant difference in different outcomes of patients in external stimulus-induced percentage of absolute power changes of admission EEG. The correlation was significantly obtained be- tween external stimulus-induced percentage of absolute power changes and GCS scores. External stimulus-induced percentage of absolute power changes of delta band and visual analysis of reactivity significantly associated with GCS score. The correlation of percentage of absolute power changes of delta band GCS score was more intensive than visual analysis of reactivity. Conclusions： Visual analysis and quantitative analysis of EEG reactivity are good factors to assess prognosis of CVD coma patients. Quantitative analysis of EEG reactivity possesses more accuracy in assessing prognosis than visual analysis of EEG reactivity.