新生儿缺氧缺血性脑损伤定量脑电图参数与神经损伤、预后的关系

The relationship between quantitative EEG parameters and neurological injury and prognosis in neonatal hypoxic-ischemic brain injury

目的探讨新生儿缺氧缺血性脑损伤定量脑电图参数变化及与患儿神经损伤、预后的关系。方法选取2019年1月至2020年12月南方科技大学医院新生儿缺氧缺血性脑损伤患儿106例进行研究。检测定量脑电图参数、神经损伤指标水平,观察定量脑电图参数与神经损伤指标关系,统计不同预后新生儿缺氧缺血性脑损伤患儿定量脑电图参数,分析定量脑电图参数对患儿预后的预测价值。结果重度脑损伤患儿O_(1)、O_(2)、T_(3)、T_(4)、Fp_(1)、Fp_(2)各位点的功率谱值均较轻度患儿低(P<0.05),重度患儿神经损伤指标水平显著高于轻度患儿(P<0.05);O_(1)、O_(2)、T_(3)、T_(4)、Fp_(1)、Fp_(2)与新生儿缺氧缺血性脑损伤患儿血清MBP、NSE水平均呈明显负相关关系(P<0.05);重度患儿后遗症发生率显著高于轻度患儿(P<0.05);有后遗症患儿O_(1)、O_(2)、T_(3)、T_(4)、Fp_(1)、Fp_(2)各位点的功率谱值较无后遗症患儿明显降低(P<0.05);绘制受试者操作特征(ROC)曲线显示,O_(1)、O_(2)、T_(3)、T_(4)、Fp_(1)、Fp_(2)联合预测新生儿缺氧缺血性脑损伤患儿出现后遗症的曲线下面积(AUC)最大,联合预测时敏感性为92.00%,特异性为85.19%。结论定量脑电图参数与新生儿缺氧缺血性脑损伤患儿神经损伤及预后有关,且对预测预后价值较高,可为临床诊治提供有力支持。

Objective To investigate the changes of quantitative EEG parameters in neonates with hypoxic-ischemic brain injury and their relationship with neurological injury and prognosis.Methods A total of 106 neonates with hypoxic-ischemic brain injury in Southern University of Science and Technology Hospital from January 2019 to December 2020 were selected for study.The levels of quantitative EEG parameters and nerve injury indexes were detected,the relationship between quantitative EEG parameters and nerve injury indexes was observed,and different prognosis quantitative EEG parameters in children with neonatal hypoxic-ischemic brain injury,and the predictive value of quantitative EEG parameters on the prognosis of children was analyzed.Results The power spectrum values of O_(1),O_(2),T_(3),T_(4),Fp_(1),and Fp_(2)in children with severe brain injury were lower than those in children with mild brain injury (P<0.05),and the nerve injury indexes levels of severe children were significantly higher than those of mild children (P<0.05).O_(1),O_(2),T_(3),T_(4),Fp_(1)and Fp_(2)were significantly negatively correlated with serum MBP and NSE levels in children with neonatal hypoxic-ischemic brain injury (P<0.05).The incidence of sequelae in severe children was significantly higher than that in mild children (P<0.05).The power spectrum values of O_(1),O_(2),T_(3),T_(4),Fp_(1)and Fp_(2)in children with sequelae were significantly lower than those in children without sequelae(P<0.05).The receiver operating characteristic (ROC) curve was drawn to show that O_(1),O_(2),T_(3),T_(4),Fp_(1)and Fp_(2)combined had the largest area under the curve (AUC) in predicting the sequelae of neonatal hypoxic-ischemic brain injury children.The sensitivity was 92.00%and the specificity was 85.19%.Conclusion Quantitative EEG parameters are related to neurological damage and prognosis in children with neonatal hypoxic-ischemic brain injury,and have high predictive value for prognosis,which can provide strong support for clinical diagnosis and treatment.