振幅整合脑电图对宫内窘迫新生儿病情严重程度的早期评估价值

Value of amplitude integrated electroencephalogram in early evaluation of severity of neonates with intrauterine distress

目的探讨振幅整合脑电图(aEEG)对宫内窘迫新生儿病情严重程度的早期评估价值,为宫内窘迫新生儿病情判断奠定理论及实践基础。方法收集2016年2月-2017年2月在该院出生并接受治疗的宫内窘迫新生儿58例作为观察组;另选取同期在医院出生的健康新生儿50例作为正常对照组。检测两组新生儿的aEEG,测定血清中神经损伤指标、心肌酶谱指标,进一步采用Pearson检验判断宫内窘迫新生儿aEEG异常程度与病情严重程度的内在联系。结果观察组患儿的aEEG背景活动、连续性、睡眠-觉醒周期异常比例均显著高于正常对照组(P<0.05);观察组患儿血清中神经损伤指标神经元特异性烯醇化酶(NSE)、神经肽Y(NPY)、S100B蛋白(S100B)的含量高于正常对照组,心肌酶谱指标肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)、天门冬氨酸氨基转移酶(AST)的含量高于正常对照组(P<0.05)。宫内窘迫患儿aEEG各项指标异常率与病情严重程度呈正相关(均P<0.05)。结论 aEEG检测结果在宫内窘迫新生儿中存在异常,且异常程度与神经系统及心肌损伤程度直接相关,有助于患儿病情严重程度的早期判断。

Objective To explore the value of amplitude integrated electroencephalogram（ a EEG） in early evaluation of severity of neonates with intrauterine distress,lay theoretical and practical foundation for predicting the severity of intrauterine distress. Methods Fiftyeight neonates with intrauterine distress born and treated in Maternal and Child Health Care Hospital of Nanshan District from February 2016 to February 2017 were chosen as observation group,and 50 healthy neonates born in the hospital during the same period were selected as normal control group. a EEG was performed in the two groups. Serum levels of nerve injury indexes and myocardial enzymes were detected. Pearson test was used to determine the internal relationship between abnormal degree of a EEG and severity of the disease. Results The proportions of neonates with abnormal a EEG background activity,continuity,and sleep-wake cycle in observation group were statistically significantly higher than those in normal control group（ P〈0. 05）. The levels of serum neuronspecific enolase（ NSE）,neuropeptide Y（ NPY）,and S100 B protein（ S100 B） in observation group were statistically significantly higher than those in normal control group（ P〈0. 05）. The levels of creatine kinase isoenzyme（ CK-MB）,lactic dehydrogenase（ LDH）,α-hydroxybutyric dehydrogenase（ α-HBDH）,and aspartate aminotransferase（ AST） in observation group were statistically significantly higher than those in normal control group（ P〈0. 05）. The abnormal rates of a EEG indexes in neonates with intrauterine distress were positively correlated with severity of the disease（ all P 0. 05）.Conclusion The results of a EEG in neonates with intrauterine distress are abnormal,and the abnormal degree is directly related to the degrees of nervous system and myocardial injury,which contributes to early prediction of severity of the disease.