脑电图空间对称指数对颈动脉狭窄后侧支循环的评估

Feasibility of electroencephalogram spatial hemispheric brain symmetry index for evaluating collateral circulation after carotid stenosis

目的采用脑电图空间对称指数(sBSI)评价颈动脉狭窄患者侧支循环代偿程度。方法选取拟行数字减影血管造影(DSA)患者61例,根据代偿程度分为1级、2级和3级,并依次分为1组(6例)、2组(22例)和3组(33例)。在DSA前行16导联脑电图常规检查,计算脑电图sBSI。根据DSA结果,判断患者颈动脉狭窄程度和侧支代偿程度。对各组患者脑电图sBSI与其影响因素进行相关和回归分析。结果所有颈动脉轻度狭窄患者代偿程度均为3级,2级代偿程度出现在部分颈动脉中、重度狭窄和闭塞患者中,1级代偿程度出现在部分重度狭窄和闭塞患者中。与3组比较,1组和2组脑电图sBSI明显升高(P<0.01)。1组与2组脑电图sBSI比较,差异无统计学意义。脑电图sBSI与狭窄程度呈正相关(r=0.541,P<0.01),与代偿程度呈负相关(r=-0.770,P<0.01)。多重回归分析显示,侧支代偿程度为脑电图sBSI独立影响因素(β=-0.029,P<0.01)。结论脑电图sBSI检查作为一项无创的检查方法,在评估患者颈动脉狭窄后侧支代偿程度方面有一定的可行性。

Objective To evaluate the feasibility of spatial hemispheric brain symmetry index （sBSI） in the EEG for evaluating collateral circulation in patients with carotid stenosis. Methods Sixty-one patients who intended to take digital subtraction angiography（DSA） examination were enrolled. EEG was performed and sBSI was calculated before DSA. DSA was used as the gold standard to determine the degree of internal carotid artery stenosis and collateral circulations. Collateral circulations were graded with a 3-point scale according to the degree of compensation, and the patients were designated as group 1（6 cases）,2（22 cases） and 3（33 cases）. Results Patients with mild stenosis all had grade-3 compensation. Patients with grade-2 compensation were found in some cases with moderate, severe stenosis and occlusion. Patients with grade-1 compensation were found in some cases with severe stenosis and occlusion. Comparing the sBSI of group 3 （0.060±0.013） with that of group 1（0. 107±0. 015） and group 2（0. 099±20. 018） ,there was significant difference （P 〈 0.01）. There was no statistical difference between group 1 and group 2. sBSI was negatively correlated with the degree of compensation （r =-0. 770, P 〈 0.01）and positively correlated with the degree of stenosis （r = 0. 541 ,P 〈 0.01）. Multiple regression analysis showed that the degree of collateral circulation was independent influential factor of sBSI （β=-0. 029,P〈0.01）. Conclusion EEG sBSI may be a feasible method for assessing the compensatory collateral circulation in patients with carotid artery stenosis.