振幅整合脑电图联合炎症指标对早产儿脑损伤的临床诊断价值

Clinical Diagnostic Value of Amplitude-Integrated Electroencephalogram Combined with Inflammatory Indicators in Premature Infants with Brain Injury

目的探讨振幅整合脑电图(aEEG)联合炎症指标对早产儿脑损伤的临床诊断价值。方法回顾性分析2021年3月至2022年12月在郑州市妇幼保健院出生的98例早产儿作为研究对象,根据诊断结果分为脑损伤组(47例)和非脑损伤组(51例),出生后12 h内检测aEEG,出生后24 h时检测白细胞计数、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)以及白介素-6(IL-6)等炎症指标。结果脑损伤组患儿aEEG评分低于非脑损伤组,白细胞计数、hs-CRP、PCT和IL-6等炎症指标高于非脑损伤组(P<0.05)。早产儿aEEG评分与白细胞计数、hs-CRP、PCT以及IL-6等炎症指标均呈负相关(r<0,P<0.05)。logistic回归分析显示,aEEG评分是早产儿脑损伤的独立保护因素,hs-CRP和IL-6均为独立危险因素(P<0.05)。单一指标对早产儿脑损伤均有诊断价值,受试者工作特征(ROC)曲线的曲线下面积(AUC)为0.619~0.702,aEEG评分、hs-CRP和IL-6联合检测的AUC为0.809,具有较高诊断价值。结论早产脑损伤患儿aEEG评分降低,炎症指标水平升高,其中aEEG评分、血清hs-CRP、IL-6指标对脑损伤均有诊断价值,且3种指标联合诊断价值最高。

Objective To investigate the clinical diagnostic value of amplitude-integrated electroencephalogram(aEEG)combined with inflammation in premature infants.Methods A retrospective analysis of 98 premature infants born in Zhengzhou Maternal and Child Health Care Hospital from March 2021 to December 2022 were selected as subjects,they were divided into brain injury group(47 cases)and non-brain injury group(51 cases)according to the diagnosis.The aEEG was measured within 12 h after birth,and inflammatory indicators of white blood cell count,hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),and interleukin-6(IL-6)were measured at 24 h after birth.Results The aEEG score of the brain injury group was lower than that of the non-brain injury group,and the inflammatory indicators of white blood cell count,hs-CRP,PCT and IL-6 were higher than those of the brain injury group(P<0.05).The aEEG score of preterm infants was negatively correlated with leukocyte count,hs-CRP,PCT and IL-6(r<0,P<0.05).Logistic regression analysis showed that aEEG score was an independent protective factor,while hs-CRP and IL-6 were independent risk factors(P<0.05).A single indicator had diagnostic value for brain injury in premature infants,the area under the curve(AUC)of the receiver operating characteristic(ROC)curve was 0.619-0.702,and the AUC of aEEG score,hs-CRP,and IL-6 combined detection is 0.809,indicating high diagnostic value.Conclusion Premature infants with brain injury have a decrease in aEEG score and an increase in inflammatory index levels.aEEG score,serum hs-CRP,and IL-6 indicators all have diagnostic value for brain injury,and the combination of the three indicators has the highest diagnostic value.