振幅整合脑电图对早产儿神经发育的预测价值

Predictive value of amplitude integrated electroencephalography for neural development of premature infants

目的探讨振幅整合脑电图(aEEG)评分联合局部血氧饱和度(SpO2)对早产儿神经发育的预测价值。方法回顾性分析2014年2月至2017年4月永康市妇幼保健院新生儿科收治的175例神经功能发育缺陷的早产儿为研究对象。于患儿生后7日及3个月时进行aEEG和局部SpO2检查,分析其在早产儿神经发育缺陷中的敏感性和特异性及早产儿的恢复情况。同时对患儿生后7天时进行神经行为测定(NBNA)评分,生后3个月行Bayley评分,评价其与早产儿神经功能发育的近期预后关系。结果 aEEG和局部SpO2均能敏感地发现早产儿神经发育缺陷,患儿在生后7日和3个月时,二者联合检测的灵敏度(70.2%,57.6%)均高于同一时期单独检测时的灵敏度(62.4%、61.7%,51.4%、52.1%)。aEEG+SpO2联合诊断的灵敏度在7天和3个月时均明显高于aEEG或SpO2单独诊断时的灵敏度(χ^2值分别为5.584、9.762、18.532、6.094,均P<0.05)。aEEG联合局部SpO2的检查结果与Bayley评分、NBNA评分结果具有良好的相关性(r值分别为-0.338、-0.621、-0.587,均P<0.05)。结论 aEEG联合局部SpO2监测能尽早发现早产儿神经发育缺陷,连续监测对早产儿神经发育缺陷的尽早治疗具有重要意义。

Objective To investigate the predictive value of amplitude integrated electroencephalography (aEEG) score and regional blood oxygen saturation (SpO2) for neural development of premature infants.Methods Retrospective analysis was conducted among 175 preterm infants with neurodevelopmental defects from February 2014 to April 2017 in Yongkang Maternal and Child Health Care Hospital.At 7 days and 3 months after birth,aEEG and local SpO2 examination were performed to explore their sensitivity and specificity in preterm infants with neurodevelopmental defects and the recovery of premature infants.At the same time,the NBNA score was measured 7 days after birth and Bayley score 3 months after birth to evaluate the short-term prognosis of neurological function development in premature infants.Results Both aEEG and local SpO2 could sensitively detect neurodevelopmental defects in premature infants.On the 7 day and 3 months after birth,the sensitivity of combining two methods in detection was 70.2% and 57.6%,respectively,which was higher than that of two examinations alone (62.4%,61.7%,51.4%,52.1%).On the 7 day and 3 months after birth,the sensitivity of aEEG+SpO2 detection in diagnosis was higher than that of two examinations alone (χ^2 value was 5.584,9.762,18.532 and 6.094,respectively,all P<0.05).The results of aEEG combined with local SpO2 showed a good correlation with Bayley score and NBNA score (r value was -0.338,-0.621 and -0.587,respectively,all P<0.05).Conclusion Amplitude integrated electroencephalogram combined with local SpO2 monitoring can detect premature infants’ neurodevelopmental defects as early as possible.Continuous monitoring is very important for early treatment of premature infants with neurodevelopmental defects.