振幅整合脑电图在新生儿缺氧缺血性脑病中的诊断价值探讨

Role of amplitude integrated electroencephalogram in diagnosis of neonatal hypoxic ischemic encephalopathy

目的了解新生儿缺氧缺血性脑病(HIE)的振幅整合脑电图(amplitude-integrated electroencephalogram,aEEG)与脐动脉血气分析、Apgar评分的关系,为新生儿HIE寻找一种有效的早期诊断方法。方法根据aEEG的检查结果,97例HIE患儿被分为aEEG正常组、aEEG轻度异常组和aEEG重度异常组。3组均进行aEEG检查、脐动脉血气分析和Apgar评分,评价aEEG与新生儿HIE临床分度、MRI分度、脐动脉血气分析、Apgar评分的关系。结果 3组的HIE临床分度的差异有统计学意义(H=6.598,P<0.05);Spearman等级相关性分析结果表明,aEEG检查结果与新生儿HIE临床分度存在统计学关联(r=0.758,P<0.05)。3组的MRI分度的差异有统计学意义(H=8.415,P<0.05);Spearman等级相关性分析结果表明aEEG检查结果与MRI分度存在统计学关联(r=0.710,P<0.05)。单因素方差分析结果表明,3组的血气p H和血气BE的差异均有统计学意义(P均<0.05),3组的1 min、5 min、10 min Apgar评分的差异均有统计学意义(P均<0.05)。结论 aEEG检查是早期诊断新生儿HIE的有效方法,具有良好的临床应用价值。

Objective To explore the relationship between amplitude-integrated electroencephalogram（ aEEG） and umbilical arterial blood gas analysis,Apgar score of neonatal hypoxic-ischemic encephalopathy（ HIE）,and to find an effective method for early diagnosis of neonatal HIE. Methods According to the results of aEEG test,97 neonates with HIE were divided into aEEG normal group,aEEG mild group and aEEG severe group. The aEEG,umbilical arterial blood gas analysis and Apgar score were performed in all the three groups. The relationship between aEEG and neonatal HIE clinical graduation,MRI graduation,umbilical arterial blood gas analysis,Apgar score of neonatal HIE were assessed. Results The differences of HIE clinical grading among the three groups were statistically significant（ H = 6. 598,P〈0. 05）;Spearman rank correlation analysis showed that the results of aEEG examination and the clinical index of neonatal HIE were statistically correlated（ r = 0. 758,P〈0. 05）. The differences of MRI grading among the three groups were statistically significant（ H = 8. 415,P〈0. 05）;Spearman rank correlation analysis showed that the results of aEEG examination and MRI grading were statistically correlated（ r = 0. 710,P〈0. 05）. One-way ANOVA showed that the differences of blood gas p H and blood gas BE in the three groups were statistically significant（ P〈0. 05）;the differences of 1 min,5 min,10 min Apgar scores among the three groups were statistically significant（ P〈0. 05）. Conclusion The aEEG examination is an effective method for early diagnosis of neonatal HIE,and has good clinical application value.