多模态神经电生理指标对意识障碍的预后评估价值

Prognostic value of multimodal neuroelectrophysiological indexes in consciousness disorders

目的探讨多模态神经电生理指标联合检测对意识障碍患者预后评估的价值。方法收集2019年1月至2023年12月期间粤北人民医院收治的48例不同程度意识障碍患者为研究对象,所有患者均采取多模态神经电生理检查,依据检查结果将其划分为不同的等级。运用二元Logistic回归分析法建立回归模型,并绘制模型对应的ROC曲线,判断模型在患者预后评估中的应用价值。结果单因素分析发现,两组患者脑电图分级、体感诱发电位分级、脑干听觉诱发电位分级、视觉诱发电位分级和事件相关电位分级对比,P<0.05。Logistic回归分析发现,EEG与患者预后的相关性最强(OR=46.739,P=0.007),BAEP等级(OR=22.737,P=0.036)及SEP等级(OR=26.513,P=0.039)次之。绘制ROC曲线发现,联合三种电生理方法所对应的AUC值最高,为0.957(P=0.000)。结论EEG、BAEP、SEP均与意识障碍患者的预后存在相关性,可为临床进行预后评估提供科学参考;而且采用三种方法联合检测的准确率更高,值得在临床应用。

Objective:To evaluate the prognostic value of multi-mode neuroelectrophysiological index combined detection in patients with consciousness disorder.Methods:48 patients with varying degrees of consciousness disorders admitted to Guangdong North People's Hospital from January 2019 to December 2023 were collected as the research subjects.All patients underwent multimodal neurophysiological examinations and were classified into different levels based on the examination results.Establish a regression model using binary logistic regression analysis and plot the corresponding ROC curve to assess the application value of the model in patient prognosis evaluation..Results:Univariate analysis revealed that the EEG grading,somatosensory evoked potential grading,brainstem auditory evoked potential grading,visual evoked potential grading,and event-related potential grading were compared between the two groups of patients,with P<0.05.Logistic regression analysis showed that EEG had the strongest correlation with patient prognosis(OR=46.739,P=0.007),followed by BAEP grade(OR=22.737,P=0.036)and SEP grade(OR=26.513,P=0.039).By plotting the ROC curve,it was found that the AUC value corresponding to the combination of three electrophysiological methods was the highest,at 0.957(P=0.000).Conclusion:EEG、BAEP and SEP are correlated with the prognosis of patients with consciousness disorders,which provides a great reference value for evaluating the prognosis.The accuracy of the combined detection of the three methods is higher,and it is more worthy of clinical application.