早产儿脑发育过程中振幅整合脑电图的变化

Changes of amplitude integrated electroencephalogram during brain development in premature

目的探讨早产儿脑发育过程中振幅整合脑电图（aEEG）的变化。 方法选取148例早产儿（胎龄28～36周），依据胎龄分为28～30周组40例，男21例，女19例；〉30～33周组49例，男25例，女24例；〉33～36周组59例，男33例，女26例。同时选取胎龄37～40周的足月新生儿40例作为对照组，男23例，女17例。采用美国Natus公司的Olympic CFM 6000脑功能监护仪检测其aEEG变化，分析aEEG的变化特点。首次监测为出生3 d，以后每周1次，监测时长2 h/次，直到早产儿出院。取监测数据的平均值作为结果进行分析，采用SAS 9.0统计学软件进行处理。 结果28～30周、〉30～33周、〉33～36周早产儿的睡眠-觉醒周期连续性电压阳性率、周期出现率与37～40周的足月新生儿比较差异均有统计学意义（均P〈0.05）。28～30周、〉30～33周、〉33～36周早产儿的安静、活动睡眠周期的波谱带下界电压值均显著低于37～40周的足月新生儿（均P〈0.05）。28～30周、〉30～33周、〉33～36周早产儿的安静、活动睡眠周期的波谱带宽度均显著宽于37～40周的足月新生儿（F＝13.444、11.982，均P〈0.05）。28～30周、〉30～33周、〉33～36周早产儿的睡眠周期总时长显著长于37～40周的足月新生儿（F＝12.451，P〈0.05）。 结论随着胎龄增加，早产儿的脑发育逐渐成熟，aEEG可在一定程度上反映早产儿脑发育的程度。

Objective To explore the changes of amplitude integrated electroencephalogram （aEEG） during brain development in premature. Methods One hundred and forty- eight premature （gestational age 28 -36 weeks） were selected. Aeeording to their gestational ages, 148 premature were divided into 28 - 30 weeks group（40 eases） ,with 21 male,19 female; 〉30 -33 weeks group （49 cases） ,with 25 male,24 female; 〉33 -36 weeks group （59 eases）, 33 male,26 female. At the same time,40 eases of gestational age 37 -40 weeks full -term newborns were selected as control group,with 23 male, 17 female. Olympic CFM 6000 cerebral funetion monitor（ produced by the American Natus company） was used to detect the changes of their aEEG,and analysis of the changes of aEEG were eondueted. The first monitor was performed 3 days after birth, then once a week, monitoring for 2 hours each time, till the premature were discharged from hospital. The average of the monitoring data was obtained as a result for the analysis, and data analysis was conducted by using SAS 9.0 statistical software. Results The sleep - wake cycle continuity voltage positive rate and cycle occurrence rate of the 28 - 30 weeks, 〉 30 - 33 weeks, 〉 33 - 36 weeks premature were significantly lower than those of the 37 - 40 weeks full - term newborns （ all P 〈 0.05 ）. The 28 - 30 weeks, 〉 30 - 33 weeks, 〉 33 - 36 weeks premature spectrum lower bound voltage value of quiet sleep cycle and activity sleep cycle were significantly lower than those of the 37 - 40 weeks full - term newborns （ all P 〈 0.05 ）. The 28 - 30 weeks, 〉 30 - 33 weeks, 〉 33 - 36 weeks premature spectrum width of quiet sleep eyele and activity sleep cycle were significantly wider than the 37 - 40 weeks full - term newborns （ F = 13. 444,11. 982, all P 〈 0.05 ）. The 28 - 30 weeks, 〉 30 - 33 weeks, 〉 33 - 36 weeks prema- ture total duration of sleep cycle were significantly higher than the 37 - 40 weeks full - term newborns （ F ： 12.451 ,P 〈 0. 05）. Conelu,sions With the increase of gestational age, premature brain development beeomes gradually mature, and aEEG can reflect the degree of premature brain development to some extent.