儿童过度换气中慢波脑电图的临床意义

The Clinical Significance of Middle and Slow Wave of EEG in Children with Hyperventilation

研究目的 探讨儿童过度换气(HV)与脑电图变化的临床意义。 研究设计 病例对照研究 患者和参与者 140例过度换气儿童(正常组),男81人,女59人,无惊厥和癫痫个人及家族史。31例有典型临床和脑电图改变的失神及精神运动型发作癫痫(病例组),年龄5～14岁。男12例,女19例。 处理方法 对正常组64例,病例组7例进行HV前、HV后2.5～3分钟、EEG复原和HV停后3～4分钟的静脉血气连续分析,并行脑电图检查和HV前血糖测定。 研究结果 正常组与病例组均有较高的慢活动发生率。正常组中14.6％(20/137)可见慢活动的一过性不对称,而病例组中出现暴发性或局限性慢活动者明显高于对照组(P均<0.01)。正常组和病例组出现早期突破分别为0和16.1％(5/37),差异非常显著(P<0.01)。HV开 始后PaCO_2显著下降,PaO_2轻度下降。正常组和病例组血糖均正常。 结论 HV对失神和精神运动性癫痫有诊断价值。慢波活动是正常儿童HV中常见图像。HV中慢活动与PaCO_2和PaO_2变化并无平行关系。

Objective To search for the relationship between children's byperventilation (HV) and the changes ofEEG. Design Case-control research. Patients and Participants 140 Children with HV (Normal group), 81 males and 59 females. all ofthem have not personal and family history of eclampsia and epilepsia. There are 31 cases of absentia andpsychomotor epilepsia with typical changes in clinic and EEG in the patient group, at the age of 5 to 14years old, 12 males and 19 females. Interventions EEG examination had been done and blood sugar had been determined before HV for allpatients and participants. The continued venous blood gas analysis had been done before and after HV 2.5to 3 minutes, after EEG recovery and HV 3 to 4 minutes for 64 cases in normal group and 7 casesin patient group. Results There is Ligher incidence rate of slow activity in normal group and patient group. 14.6% innormal group show transient dissymmetry slow activity the incidence rate of fulminant or localized slowactivity is obviously higher in patient group than that in normal group (P<0.01). The incideuce rates ofearly break are 0 and 16.1% in normal and patient group. (P<0.01). PaCO_2 is obviously decreased,PaO_2 is lightly decreased. After beginning HV.The blood sugar is all normal in normal group and patientgroup. Conclusions HV has diagnosis value for absentia and psychomotor epilepsy. Slow wave activity isthe common picture in the normal children's HV. The middle and slow activities and PaCO_2, PaO_2 areno relationship of equal rank in HV.