振幅整合脑电图评分系统在低血糖早产儿脑功能评价中的作用

The effect of the scoring system of amplitude integrated electroencephalogram in assessing the cerebral function in premature infants with hypoglycemia

目的研究振幅整合脑电图（aEEG）评分系统在早产儿低血糖性脑损伤（HBD）中的变化特点及其对早产儿HBD的预测作用。方法选取28例低血糖早产儿，分别于发现低血糖当时、低血糖纠正后7d行aEEG描记，利用aEEG评分系统分析背景波连续性、睡眠觉醒周期（SWC）、下边界振幅及带宽的变化特点，并与血糖正常早产儿作对照，比较各参数校正后分值。校正后分数越高，提示aEEG异常程度越重。结果对aEEG各参数进行组间比较，其中低血糖组及对照组、症状性低血糖组和无症状性低血糖组之间校正后SWC及校正后总分，前者均高于后者，差异均有统计学意义（均P〈0．05）。结论aEEG评分系统可反映早产儿低血糖时脑功能的改变，对早产儿HBD具有预测、评估严重程度等作用。

Objective To assess the finding of the scoring system of amplitude integrated electroencephalogram （aEEG） and its predictive value in premature hypoglycemic brain damage （HBD）, and search clinical operational threshold of premature hypoglycemia. Methods Twenty-eight premature infants diagnosed with hypoglycemia were selected. 8-hour continuous aEEG recording were performed on the day when hypoglycemia was diagnosed and 7 d later, aEEG recordings were evaluated using the scoring system for record continuity, sleep-waking cycle （SWC）, degree of voltage amplitude depression, and bandwidth. Each variable was scored for each recording. All variables were summed to yield a total score. All scores were correlated with gestational and postconceptional ages, called adjusted scores（AS）, and compared with those of non-hypoglycemic premature infants. Higher AS suggested worse outcomes. Results The AS of SWC and total scores in hypoglycemic group were significantly higher than those in control group （P〈0.05）. The AS of SWC and total scores in symptomatic hypoglycemic group were significantly higher than those in asymptomatic hypoglycemic group （P〈0.05）. Conclusions The aEEG scoring system can objectively and directly reflect the function and lesion extent of damaged brain cells and provide a tool for early evaluating the degree of hypoglycemic brain damage.