脑电图预测大面积大脑中动脉供血区梗死的恶性过程  

Prediction of malignant course in large midge cerebral artery infarction by electroencephalography

作　　者：任雅芳[1] 吴永明[1] 姬仲[1] 喻燕[1] 王静新[1] 潘速跃[1] 

机构地区：[1]南方医科大学南方医院神经内科,广州510515

出　　处：《国际脑血管病杂志》2010年第4期249-253,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨脑电图（electroenphalography，EEG）对大面积大脑中动脉供血区梗死（large middle cerebral artery infarction,LMCAI）患者神经功能恶化的预测价值。方法共纳入37例早期CT和（或）MRI显示脑梗死面积〉大脑中动脉供血区50％的卒中患者，其中20例为恶性过程（恶性组），17例为良性过程（良性组）；恶性组格拉斯哥-匹兹堡昏迷量表评分[（24±7）对（30±4），P=0．003]和美国国立卫生研究院卒中量表评分[（23±3）对（16±4），P=0．000]显著高于良性组。记录卒中发病24h内的早期EEG。分析EEG变化特征与恶化性进程的相关性。结果对侧枕部背景频率〈8Hz（17／20对3／20，P=0．000）、病灶内B频率≤20Hz（19／26对7／26，P=0．001）、外界刺激时EEG无反应（11／12对1／12，P=0．002）、病灶侧半球弥漫性慢波（17／24对7／24，P=0．008）以及对侧局部慢活动（16／19对3／19，P=0．001）等与恶性过程相关，而病灶对侧枕部脑电活动频率≥8Hz（14／17对3／17，P=0．000）和病灶内β频率〉20Hz（10／11对1／11，P=0．001）与良性过程相关。结论早期EEG对LMCAI恶性过程有一定的预测价值，可作为LMCAI患者的床边监测手段之一。Objective To explore the predictive value of early electroenphalography （EEG） for a malignant course in patients with large middle cerebral artery infarction （LMCAI）. Methods Thirty-seven patients （20 patients with a malignant and 17 with a benign course） with stroke of 〉50% of the middle cerebral artery territory in early CT/MRI scan were included; Glasgow-Pittsberg Coma Scale （24±7 vs. 30±4, P =0. 003） and National Institutes of Health Stroke Scale （23 ±3 vs. 16 ±4, P =0. 000） in the group with a malign course were higher than those in the group with a benign course. Early EEG was recorded within 24 h after ischemic stroke. The correlation between the change characteristics of EEG and a malignant course in patients with LMCAI was analyzed. Results The contralateral occipital background frequencies 〈 8 Hz （17/20 vs. 3/20, P =0.000）, β frequency within the focus ≤20 Hz （19/26 vs. 7/26, P=0.001）, EEG non-reaction to stimuli （11/12 vs. 1/12, P=0.002）, slowing affecting the whole hemisphere in the lesion （17/24 vs. 7/24, P=0. 008） and focal slowing contralateral to the lesion （16/19 vs. 3/19, P =0. 000） were significantly related with a malignant course. Whereas the contralateral occipital background frequencies ≥ 8 Hz （14/17 vs. 3/17, P =0. 000）, β frequency 〉20 Hz within the focus （10/11 vs. 1/11, P =0.001） were related with a benign course. Conclusions Early EEG has a certain predictive value for a malignant course in patients with LMCAI, and it may be used as one of the bedside monitoring approaches of LMCAI.

关 键 词：脑梗死 梗死 大脑中动脉 脑电描记术 疾病恶化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]