振幅整合脑电图对新生儿缺氧缺血性脑病诊断及预后评估的价值

Values of amplitude integrated electroencephalogram in the diagnosis and prognosis evaluation of neonatal hypoxic-ischemic encephalopathy

目的探索振幅整合脑电图(aEEG)对新生儿缺氧缺血性脑病(HIE)诊断及预后评估的价值。方法将47例HIE新生儿根据HIE新生儿临床症状程度分为重度HIE新生儿(n=6)、中度HIE新生儿(n=16)、轻度HIE新生儿(n=25)。新生儿均实施aEEG监测。比较不同HIE分度、aEEG分度新生儿治疗前、后的各项预后指标评分。比较不同aEEG分度新生儿的S100β蛋白、SBDPs及Tau水平。结果各HIE分度及各aEEG分度新生儿治疗后的NBNA、PDI及MDI评分均高于治疗前(P<0.05)。轻度HIE新生儿NBNA、PDI及MDI评分恢复情况优于中度、重度HIE新生儿(P<0.05)。正常aEEG新生儿NBNA、PDI及MDI评分恢复情况优于轻度、重度异常aEEG新生儿(P<0.05)。S100β蛋白、SBDPs、Tau水平:重度异常aEEG新生儿>轻度异常aEEG新生儿>正常aEEG新生儿(P<0.05)。结论aEEG在HIE新生儿病情评估、早期诊断、预后判断中具有较好的应用价值。

Objective To explore the values of amplitude integrated electroencephalogram(aEEG)in the diagnosis and prognosis evaluation of neonatal hypoxic-ischemic encephalopathy(HIE).Methods Forty-seven cases of HIE neonates were divided into severe HIE neonates(n=6),moderate HIE neonates(n=16)and mild HIE neonates(n=25)according to the clinical symptoms of HIE.The neonates were given aEEG monitoring.The prognosis indexes scores of neonates with different HIE and aEEG degree before and after treatment were compared.The levels of S100β protein,SBDPs and Tau in neonates with different aEEG degree were compared.Results The scores of NBNA,PDI and MDI in neonates with each HIE and aEEG degree after treatment were higher than those before treatment(P<0.05).The recovery of NBNA,PDI and MDI scores in neonates with mild HIE were better than those in neonates with moderate and severe HIE(P<0.05).The recovery of NBNA,PDI and MDI scores in neonates with normal aEEG were better than those in neonates with mild and severe abnormal aEEG(P<0.05).The levels of S100βprotein,SBDPs and Tau were as follows:severe abnormal aEEG newborn>mild abnormal aEEG newborn>normal aEEG newborn(P<0.05).Conclusion The aEEG has better application value in disease condition evaluation,early diagnosis and prognosis judgment of HIE neonate.