颈动脉狭窄支架成形术实施前后患者定量脑电图分析研究

QEEG Changes in Patients with Carotid Stenosis before and after the Carotid Artery Stenting

目的观察颈动脉狭窄支架成形术(CAS)实施前后患者定量脑电图(QEEG)功率谱的变化,探讨其在CAS实施后脑功能改善程度的评估价值。方法选取2014年1月—2015年10月滨州医学院附属医院实施CAS的颈动脉狭窄患者36例,均于CAS实施前、后进行脑电图(EEG)检查。记录EEG检查结果,测量双侧前额区(FP_1、FP_2)、中央区(C_3、C_4)、枕区(O_1、O_2)、颞区(T_3、T_4)各频段(δ﹢θ)/(α﹢β)的相对功率比值(DTABR)。结果 CAS实施前,EEG检查结果正常9例,轻度异常15例,中度异常10例,重度异常2例。CAS实施后,EEG检查结果正常12例,轻度异常17例,中度异常6例,重度异常1例。CAS实施前、后EEG检查结果比较,差异无统计学意义(Z=-1.882,P=0.060)。CAS实施前、后双侧枕区(O_1、O_2)DTABR比较,差异无统计学意义(P>0.05);CAS实施后双侧前额区(FP_1、FP_2)、中央区(C_3、C_4)、颞区(T_3、T_4)DTABR均低于CAS实施前(P<0.05)。结论 CAS实施前、后QEEG在前头部有明显变化,可能与颈动脉在头部血流分布特点有关。QEEG可作为评价重度颈动脉狭窄患者CAS实施前、后脑功能改善的有效参考指标之一。

Objective To study the quantitative electroencephalogram （QEEG） power spectrum changes in patientswith carotid stenosis before and after the carotid artery stenting （ CAS） and explore its value for brain function in these patients after CAS. Methods This retrospective study was conducted in 36 patients performed CAS in Binzhou Medical University Hospital from January 2014 to October 2015. Electroencephalogram （ EEG） was performed in the patients before and after the procedure and the results were recorded. The relative power ratio of （8 ＋ 0 ） / （ a ＋ p ）（DTABR） at bilateral prefrontal electrodes （ FP1, FP2 ）, central electrodes （ C3, C4 ）, occipital electrodes （ O1, O2 ） and temporal electrodes （ T3, T4 ） in the patients after CAS were calculated and compared with those before the procedure. Results Before the procedure, EEG results were normal in 9 cases, mild abnormalities in 15 cases, moderate abnormalities in 10 cases, and severe abnormalities in 2 cases; after the procedure, EEG results were normal in 12 cacases, moderate abnormalities in 6 cases,and severe abnormalities in 1 case,which showed that the EEG results of the patientsbefore and after the CAS had no significant differences （Z = - 1. 882, P - 0 . 060） . Compared with before the CAS, after the CAS,DTABR at bilateral occipital electrodes （ O1, O2 ） did not change significantly （ P 〉 0. 05 ）, but the DTABR at bilateral prefrontal electrodes （ FP1, FP2 ）, central electrodes （ C3, C4 ） ,and temporal electrodes （ T3, T4 ） decreased substantially（P 〈 0.05 ） . Conclusion QEEG changed a lot at the prefrontal areas after the CAS, which may be associated with the cerebralcarotid artery blood flow distribution. So QEEGcan be regarded as an effective index for evaluating the degree of improvement inbrain function in patients with carotid stenosis after CAS.