小儿病毒性脑炎动态脑电图改变与血清NSE水平相关性

Correlation between changes of ambulatory electroencephalogram and serum NSE level in children with viral encephalitis

目的分析小儿病毒性脑炎(VE)动态脑电图(AEEG)改变与血清神经元特异性烯醇化酶(NSE)水平相关性。方法选取本院2017年8月至2020年8月108例疑似VE患儿,行AEEG检查(异常101例),以临床诊断为标准,分析AEEG检查诊断价值及与临床诊断病情程度一致性。根据AEEG检查异常程度分为重度异常组(12例)、中度异常组(25例)、轻度异常组(64例),比较3组血清NSE水平、3个月预后情况,分析AEEG检查异常程度与血清NSE相关性及与预后的关系。结果108例疑似VE患儿,临床确诊103例。AEEG检查诊断VE敏感度为98.06%,特异度为100%,准确度为98.15%。AEEG检查异常程度与临床诊断病情程度一致性较高(P<0.05)。随VE患儿AEEG异常程度加重,血清NSE水平明显升高,差异具有统计学意义(P<0.05)。AEEG检查异常程度与血清NSE水平存在正相关性(P<0.05)。重度异常组预后不良率高于中度异常组、轻度异常组,差异具有统计学意义(P<0.05)。AEEG检查异常程度与预后呈正相关(P<0.05)。AEEG检查重度异常患儿预后不良相对风险HR值最大,为6.207。结论AEEG检查有望成为小儿VE早期诊断与预后评估的一项有效辅助手段。

Objective To analyze the correlation between ambulatory electroencephalogram(AEEG)changes and serum neuron-specific enolase(NSE)level in children with viral encephalitis(VE).Methods A total of 108 children with suspected VE from August 2017 to August 2020 in our hospital were selected for AEEG examination.The clinical diagnosis was adopted as the standard,and the diagnostic value of AEEG examination and its consistency with clinical diagnosis were analyzed.According to the degree of abnormality in AEEG examination,they are divided into the severe abnormality group,the moderate abnormality group,and the mild abnormality group.Serum NSE level and prognosis at 3 months were compared among the 3 groups,and the correlation between abnormal degree of AEEG and serum NSE and prognosis was analyzed.Results Among 108 children with suspected VE,103 cases were clinically confirmed.The sensitivity of AEEG diagnosis of VE was 98.06%,the specificity was 100%,and the accuracy was 98.15%.The degree of abnormality in AEEG examination was consistent with the degree of clinical diagnosis(P<0.05).With the aggravation of the abnormal degree of AEEG in children with VE,the serum NSE level increased significantly,and the difference was statistically significant(P<0.05).The degree of abnormality of AEEG examination was positively correlated with serum NSE level(P<0.05).The poor prognosis rate of the severe abnormality group was higher than that of the moderate abnormality group and the mild abnormality group,and the difference was statistically significant(P<0.05).The degree of abnormality in AEEG examination was positively correlated with the prognosis(P<0.05).The relative risk of poor prognosis in children with severe abnormalities in AEEG examination was the highest,which was 6.207.Conclusion AEEG examination is expected to be an effective aid for early diagnosis and prognostic evaluation of VE in children.