急性脑梗死患者脑电图变化及临床意义

Changes and clinical significance of electroencephalogram in patients with acute cerebral infarction

观察急性脑梗死患者脑电图变化及临床意义.方法选择2017年1月至2019年1月浙江萧山医院收治的急性脑梗死患者96例作为观察组,选择同期同年龄段在该院进行健康体检健康人员96例作为对照组,所有参与研究人员给予脑电图检查,比较两组患者α、β、δ、θ以及DTABR值,比较观察组局灶性脑梗死、大面积脑梗死患者α、β、δ、θ以及DTABR值,观察影响预后良好组和预后不良组患者因素,并以患者预后为应变量对患者进行logistic多因素回归分析,分析影响患者预后的因素.结果观察组患者δ、θ及DTABR值分别为(43.26 ±10.51) Hz、(29.30 ±9.88) Hz、(1.14 ±0.40 ),均高于对照组的(22.49 ± 5.37)Hz、(26.42 ±5.73)Hz、(0.92 ±0.37)(t=17.243,P=0.000;t=2.471,P=0.014;t=3.956,P=0.000);观察组α、β分别为(17.83 ±5.27)Hz、(9.07 ±5.15) Hz,低于对照组的(35.42 ±7.06) Hz、(16.29 ±5.44) Hz (t=19.563,P=0.000;t=9.443,P=0.000).局灶性脑梗死患者α、θ分别为(15.94 ±5.33) Hz、(30.76 ± 10.02)Hz,均高于大面积脑梗死患者的(11.37 ±4.06)Hz、(27.55 ±7.75)Hz(t=6.683,P=0.000;t=2.483, P=0.014).局灶性脑梗死患者δ、DTABR分别为(37.42 ±5.33)Hz、(1.03 ±0.52) Hz,均低于大面积脑梗死患者的(52.36 ±5.21)Hz、(1.48 ±0.45)Hz(t=19.640,P=0.000;t=6.412,P=0.000).两组患者β差异无统计学意义(P>0.05);预后良好组患者患侧α、患侧β分别为(27.18 ±9.65) Hz、(14.83 ±5.06) Hz,均高于预后不良组的(14.06 ±3.94)Hz、9.03 ±4.33)Hz(t=8.034,P=0.000;t=5.841,P=0.000).患侧δ、患侧θ、患侧DTABR、患侧/健侧DTABR分别为(31.42 ±9.83)Hz、(32.19 ±8.57) Hz、(0.916 ±0.371) Hz、(1.051 ± 0.246),低于预后不良组的(40.13 ±14.37)Hz、(37.44 ±10.11)Hz、(1.331 ±0.712)Hz、(1.376 ±0.352)(t=3.529,P=0.001;t=2.739,P=0.007;t=3.728,P=0.000;t=5.329,P=0.000).以患者预后为应变量对患者进行logistic多因素回归分析,患侧/健侧DTABR是影响急性脑梗死患者预后的因素.结论急性脑梗死患者脑电图会出现δ、θ以及DTABR值升高,α、β降低情况,而患侧/健侧DTABR是影响患者预后的因素.

Objective To observe the changes of electroencephalogram (EEG) and its clinical significance in patients with acute cerebral infarction.Methods From January 2017 to January 2019,96 patients with acute cerebral infarction treated in Zhejiang Xiaoshan Hospital were randomly selected as observation group ,and 96 healthy persons of the same age from the same period in our hospital were selected as control group.All the participants were given EEG examination.The values of alpha,beta,delta,theta and DTABR were compared between the two groups.The focal cerebral infarction and large area cerebral infarction in observation group were compared .The values of alpha,beta, delta,theta and DTABR of the dead patients were observed ,and the factors affecting the prognosis of the patients with good prognosis and poor prognosis were observed.Logistic multivariate regression analysis was carried out with the prognosis of the patients as a strain to analyze the factors affecting the prognosis of the patients .Results The values of delta,theta and DTABR of patients in the observation group were (43.26 ±10.51)Hz,(29.30 ±9.88)Hz,(1.14 ± 0.40),respectively,which were higher than those in the control group [(22.49 ±5.37) Hz,(26.42 ±5.73) Hz,(0.92 ±0.37)](t=17.243,P=0.000;t=2.471,P=0.014,P=0.014;t=3.956,P=0.000).The alpha and theta of patients with focal cerebral infarction were (15.94 ±5.33)Hz and (30.76 ±10.02)Hz,respectively,which were higher than those of patients with large cerebral infarction [(11.37 ±4.06) Hz and (27.55 ±7.75) Hz]( t=6.683,P=0.000;t=2.483,P=0.014).Delta and DTABR in patients with focal cerebral infarction were (37.42 ± 5.33)Hz and (1.03 ±0.52)Hz,which were lower than those of patients with massive cerebral infarction [(52.36 ± 5.21)Hz and (1.48 ±0.45)Hz](t=19.640,P=0.000;t=6.412,P=0.000).There was no significant difference in beta between the two groups (P>0.05).The patients with good prognosis had higher levels of alpha and beta on the affected side[(27.18 ±9.65)Hz and (14.83 ±5.06)Hz] than those with poor prognosis [(14.06 ±3.94) Hz and 9.03 ±4.33)Hz](t=8.034,P=0.000;t=5.841,P=0.000).The delta,theta,DTABR of affected side,affected side DTABR/contralateral DTABR were (31.42 ±9.83)Hz,(32.19 ±8.57) Hz,(0.916 ±0.371) Hz,(1.051 ± 0.246),respectively,which were lower than those of patients with poor prognosis [(40.13 ±14.37) Hz,(37.44 ± 10.11)Hz,(1.331 ±0.712)Hz,(1.376 ±0.352)]( t=3.529,P=0.001;t=2.739,P=0.007;t=3.728,P=0.000;t=5.329,P=0.000).Logistic multivariate regression analysis was used to analyze the prognosis of patients with acute cerebral infarction.DTABR on the affected/healthy side was the factor influencing the prognosis of patients with acute cerebral infarction.Conclusion EEG in patients with acute cerebral infarction may increase the value of delta,theta and DTABR,and decrease the value of alpha and beta.DTABR in the affected side and the contralateral side is the prognostic factor.