重症脑功能损伤的脑电图分级标准研究  

Electroencephalography grading standard research in severe cerebral dysfunction

作　　者：王晓梅[1] 宿英英[1] 

机构地区：[1]首都医科大学宣武医院神经内科重症监护病房,北京100053

出　　处：《中华神经科杂志》2005年第2期104-107,共4页Chinese Journal of Neurology

基　　金：北京市科委资助项目(953304003)

摘　　要：目的比较不同脑电图分级标准对脑血管疾病(cerebralvasculardisease, CVD)组和心肺复苏(cardio pulmonaryresuscitation, CPR)组脑功能损伤评价和预测预后的作用,旨在建立脑功能损伤的脑电图评估标准。方法对40例大脑半球病变的急性脑血管疾病患者和25例心跳呼吸骤停复苏后缺氧性脑病患者进行脑电图监测,并根据3种不同分级标准(Lavizzari、Synek和Young分级标准)进行脑电图分析。结果两组患者应用3种不同标准的脑电图分级与预后其相关性均有统计学意义(P<0. 01),脑电图级别越高,预后越差。经Logistic回归分析,重症CVD组Synek分级标准预测准确率最高(89. 2% );CPR组Synek分级标准和Young分级标准的预测准确率均最高(均为92% ),其中Young分级标准的相符性更好(Kappa=0. 943)。结论Synek分级标准能更好地反映脑血管疾病的脑功能损伤程度,并能较为准确地预测预后。而Young分级标准则能更好地反映缺氧性脑病的脑功能损伤程度及预后。Objective To compare the predicting accuracy of different electroencephalography(EEG)grading standards in two different types of cerebral dysfunction.Methods The EEG of all the 40 patients who suffered from acute cerebrovascular disease(CVD)in the hemisphere and 25 patients suffering from cardio-pulmonary resuscitation(CPR)were recorded continuously, and EEG grading according to three different EEG grading standards(Lavizzari, Synek and Young)was made. Results Three different EEG grading standards of two groups showed a much closer correlation with the outcome(P<0.01):the higher the EEG grade was, the poorer the outcome was. Logistic regression showed that:in CVD group the Synek standard was best for predicting accuracy(89.2%); in CPR group the Synek and Young standards were similar for predicting accuracy(92%), but Young standard was better than Synek standard in Kappa ^(0.943) .Conclusion The EEG grading standard of Synek reflected the change of CVD well; the EEG grading standard of Young showing the change of CPR well should be a reliable predictor for its outcome.

关 键 词：重症脑功能损伤 脑电图 分级标准 预后 脑血管意外 

分 类 号：R743.3[医药卫生—神经病学与精神病学]