振幅整合脑电图在新生儿缺氧缺血性脑病中的变化

The changes of amplitude-integrated electroencephalogram in full term newborns with hypoxic-ischemic encephalopathy

目的了解振幅整合脑电图（amplitude—integratedelectroencephalogram，aEEG）在新生儿窒息后缺氧缺血性脑病（hypoxic—ischemicencephalopathy，HIE）中的变化规律。方法选择2011年8月至2012年1月入住白求恩国际和平医院新生儿重症监护病房的35例窒息合并HIE的足月新生儿为HIE组，胎龄为37～41周，同时选取40例足月正常新生儿作为对照组。采用国产脑功能监护仪（CF3000）分别对研究对象于生后24～48h内监测aEEG波谱带的变化，每次连续监测8h，从振幅波形的连续性、睡眠-觉醒周期及其振幅的高低来分析aEEG的变化。结果（1）HIE组35例患儿aEEG最高振幅为16μV，最低振幅为7μV，而对照组最高振幅为30μV，最低振幅为13μV，两组间比较差异有统计学意义（P〈0．05）；（2）HIE组患儿的睡眠-觉醒周期出现率与对照组比较[20％（7／35）VS100％（40／40）]，差异有统计学意义（x^2=51．064，P〈0．05），其出现连续性振幅比率与对照组比较[31％（11／35）vs100％（40／40）]，差异有统计学意义（x^2=40．336，P〈0．05）。结论窒息后脑损伤aEEG有特异性表现，可较早预测窒息后引起的脑损伤，对HIE的早期诊断和治疗提供依据。

Objective To prospectively observe the changes of amplitude-integrated electroencepha- logram（aEEG） in neonates with hypoxic-ischemic encephalopathy （HIE）. Methods Thirty-five HIE neonates with gestational age of 37 -41 weeks were chosen as HIE group, and all of them were hospitalized in neonatal intensive care unit of Bethune International Peace Hospital from Aug 2011 to Jan 2012. At the same time ,40 healthy term neonates were chosen as control group, aEEG monitoring was done within 24 ~ 48 hours after birth with cerebral function monitor（CF3000） and each recording last at least 8 hours. The continuity, sleep-wake cycle, voltage of every aEEG tracing were analyzed. Results （ 1 ） The maximal voltage of aEEG tracing in control group was 30 μV ,while that in HIE group was 16 μN. The minimal voltage of aEEG tracing in control group was 13 μV, while that in HIE group was 7μV. The aEEG tracing amplitude both in highest and lowest in HIE group were significantly lower than those in the control group. There were significant differences between them （ P 〈 0. 05 ）. （ 2 ） There was significant difference of sleep-wake cycling between HIE group and control group[20% （7/35） vs 100% （40/40） ,X^2 =51. 064,P 〈0. 05]. While there was also significant difference of the continuity of the amplitude between HIE group and control group E 31% （ 11/35 ） vs 100% （40/40）, x^2 = 40. 336 ,P 〈 0.05 ]. Conclusion aEEG has some specific changes in neonates with HIE,possiblility it can be used for earlier predicting the occurrence of brain damage after asphyxia and provides good evidence for the early diagnosis and treatment of HIE.