振幅整合脑电图针对ICU脑卒中患者预后的早期评价作用

Early Evaluation of Amplitude Integrated Electroencephalography on the Prognosis of Patients in ICU

目的探讨振幅整合脑电图(aEEG)评估ICU脑卒中昏迷患者预后的早期评价作用。方法选取ICU脑卒中昏迷患者31例,采用Nicolet Monitor脑电测量系统收集患者发病72 h内的aEEG,评估并记录患者格拉斯哥昏迷评分(GCS)以及患者转出ICU时脑功能评价量表(CPC)评分。结果aEEGⅠ级8例、Ⅱ级12例、Ⅲ级11例;GCSⅠ级8例、Ⅱ级12例、Ⅲ级11例;脑功能预后良好9例,不良22例;aEEG分级与GCS分级呈正相关(r=0.742,P<0.01);GCS分级与CPC评分呈正相关(r=0.622,P<0.01);aEEG分级与CPC评分呈正相关(r=0.707,P<0.01);aEEG分级线下面积(0.922)大于GCS分级线下面积(0.871),在最佳截断值1.5时,aEEG(敏感度95.5%、特异度77.8%)较GCS(敏感度90.9%、特异度66.7%)高,差异有统计学意义(P<0.05)。结论aEEG可作为ICU脑卒中昏迷患者脑功能预后的早期评价指标,其预测能力高于GCS评分。

Objective To explore the early prognostic value of amplitude integrated electroencephalography(aEEG)in ICU patients with stroke coma.Methods 31 ICU patients with stroke and coma were selected,and the aEEG was collected within 72 hours of the onset of the disease using the Nicolet Monitor electroencephalography measurement system.The Glasgow Coma Score(GCS)and the Brain Function Assessment Scale(CPC)score at the time of patient transfer were evaluated and recorded.Results A total of 31 patients were enrolled,including 11 females and 20 males,aged 68.14±2.86 years.There were 8 cases of aEEG I,12 cases of gradeⅡ,and 11 cases of gradeⅢ.8 cases of GCS I,12 cases of gradeⅡ,11 cases of gradeⅢ;9 cases had good prognosis of brain function and 22 cases were poor;There was a positive correlation between aEEG and GCS(r=0.742,P<0.01);there was a positive correlation between GCS and CPC(r=0.622,P<0.01);there was a positive correlation between aEEG and CPC(r=0.707,P<0.01);the area under aEEG(0.922)was larger than that under GCS(0.871).The best cutoff value was 1.5,aEEG(sensitivity 95.5%,specificity 77.8%)was higher than GCS(sensitivity 90.9%,specificity 66.7%)and the difference was statistically significant(P<0.05).Conclusion The aEEG is effective in evaluating the prognosis of coma patients in ICU.