产前应用地塞米松对晚期早产儿振幅整合脑电图的影响

Effect of prenatal application of dexamethasone on amplitude-integrated electroencephalogram in late preterm infants

目的 通过分析产前应用地塞米松的晚期早产儿振幅整合脑电图(Amplitude integrated electroencephalogram, aEEG)的数据变化特点,探讨分娩前应用地塞米松对晚期早产儿神经系统的影响。方法 收集58例晚期早产儿在出生后72 h内及出生后7 d的aEEG资料,分析带宽、睡眠周期、边界电压及背景活动,对比产前2周内曾应用地塞米松与产前未应用地塞米松的晚期早产儿aEEG数据资料。结果 产前应用地塞米松组纳入30例晚期早产儿,产前未应用地塞米松组纳入28例晚期早产儿,在出生后72 h内aEEG参数比较中,产前应用地塞米松组患儿活动睡眠期的上边界电压低于未应用组,活动睡眠期及安静睡眠期的下边界电压高于未应用组,差异有统计学意义(P<0.05);在出生后7 d的aEEG参数对比中,产前应用地塞米松组患儿活动睡眠期及安静睡眠期的下边界电压高于未应用组,安静睡眠期的带宽窄于未应用组,差异有统计学意义(P<0.05)。而在背景活动与睡眠周期的比较中,两组患儿在不同aEEG采集时间段内,差异均无统计学意义(P>0.05)。结论 产前应用地塞米松可使晚期早产儿的脑电活动更为成熟,促进了晚期早产儿脑的发育。

Objective To investigate the effects of prenatal dexamethasone on the neurological system of late preterm infants by analyzing the characteristics of the data of amplitude-integrated electroencephalogram(aEEG)of the late preterm infants who had received dexamethasone prenatally.Methods The aEEG data of 58 late preterm newborns were collected within 72 hours and 1 week after birth.The span,border voltage,sleep cycle and background activity were analyzed,and the aEEG data of late preterm infants with dexamethasone applied during the 2-week prenatal period and those without prenatal application of dexamethasone were compared.Results Thirty late preterm infants were included in the group with prenatal application of dexamethasone,and 28 late preterm infants were included in the group without prenatal application of dexamethasone.In the comparison of aEEG parameters within 72 hours after birth,the upper border voltage of active sleep was lower in the prenatal dexamethasone group than in the no-application group,while the lower border voltage of active sleep and quiet sleep was higher than the no-application group,with a significant difference(P<0.05).In the comparison of aEEG parameters at 7 days after birth,the lower border voltage of active sleep and quiet sleep in the prenatal dexamethasone group was higher than that in the no-application group,and the span of quiet sleep was narrower than that in the no-application group,with a significant difference(P<0.05).In the comparison of background activity and sleep cycle,there was no significant difference between the two groups during different aEEG collection time periods(P>0.05).Conclusion Prenatal application of dexamethasone can make the brain electrical activity of late preterm infants more mature,promoting the development of the brain in late preterm infants.