定量脑电图对大面积大脑中动脉供血区梗死患者预后的预测价值  

Prognostic predictive value of quantitative electroencephalography for patients with large middle cerebral altery infaction

作　　者：田歌[1,2] 潘速跃[1] 吴永明[1] 王胜男[1] 林镇洲[1] 王静新[1] 张晓梅[1] 姬仲[1] 

机构地区：[1]南方医科大学南方医院神经内科,广州510515 [2]中山大学肿瘤防治中心,华南肿瘤学国家重点实验室,广州510060

出　　处：《国际脑血管病杂志》2012年第3期170-176,共7页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨定量脑电图（quantitativeelectroencephalogyaphy，qEEG）对大面积大脑中动脉供血区梗死（1argemiddlecerebralarteryinfarction，LMCAI）患者预后的预测价值。方法在脑梗死发病后72h内记录患者的常规脑电图、qEEG和格拉斯哥昏迷量表（GlasgowComaScale，GCS）评分结果，在发病1个月后评价近期预后（死亡或存活），在发病3个月后评价远期预后，对各预后组各项观察数据进行比较。结果共纳入105例患者，近期存活组与死亡组之间振幅整合脑电图（amplitudeintegratedelectroencephalogram,aEEG）边界[上边界：（19．11±7．80）μV对（11．87±6．41）μV；t=2．392，P=0．019；下边界：（11．90±4．78）州对（7．58±4．15）μV；t=3．327，P=0．022]、Synek分级（X2=48．114，P=0．000）存在显著性差异；左侧LMCAI患者B活动绝对功率[（13．16±12．66）μV2对（19．20±17．96）μV2；T=-2．781，P=0．039]和频谱边缘频率95％（spectraledgefrequency95％，SEF95％）[（9．17±3．24）Hz对（10．36±3．76）Hz；t=-5．614，P=0．002）存在显著性差异。远期预后良好组与预后不良组之间年龄[（59．33±13，67）岁对（68．87±10．473）岁；t=-3．215，P=0．002]、GCS评分[（10．86±2．80）分对（9．21±2．51）分；t=2．511，P=0．015]、SEF95％[（13．80±5．40）Hz对（10．93±4．68）Hz；t=2．311，P=0．024]和梗死侧别（x2=4．737，P=0．030）存在显著性差异。结论qEEG可作为预测uⅥCAI患者预后的一种有效监测手段。Objective To study the prognostic predictive value of quantitative electroencephaloffaphy （qEEG） for patients with large middle cerbral artery infarction （LMCAI）. Methods The scores of routine electroencephalo- gaphy （EEG）, qEEG and the Glasgow Corm Sca/e （GCS） of the patients within 72 hours after symptom onset were recorded. The short-term prognosis （death or survival） was evaluated at 1 month after the onset. The long-term prognosis （good or poor） was evaluated at 3 months after the onset. All the observed data in each prognostic group were compared. Results A total of 105 patients were included in the study. There were significant differences in the margin of amplitude integated electroencephalogarn （aEEG） （upper margin： 19. 11 ± 7.80 μV vs. 11.87 ± 41μV; t =2. 392, P =0. 019; lower rmrgin： 11.90±4. 78μV vs. 7. 58 ±4. 15 μV; t =3. 327, P =0. 022）, Synek-classification （Xz =48. 114, P =0. 000） between the short-term survival group and the death group; in patients with left LMCAI, there were sigfificant differences in the absolute energy of the 13-activity （13. 16 ± 1Z 66 μV~ vs. 19. 20 ± 17. 96 μV2; t = -2. 781, P =0. 039）, spectral edge frequency 95% （SEF95%） （9. 17 ±3. 24 Hz vs. 10. 36 ±3. 76 Hz; t = -5. 614, P =0. 0）2） between the short-term survival group and the death group. There were significaut differences in the age（59.33±13.6;7 years vs. 68.87± 10.473 years; t= -3.215, P= 0. 002）, GCS scores （10.86±2.80 vs. 9.21 ±Z51; t =2. 511, P =0. 015）, SEF95% （13. 80 ±5. 40 Hz vs. 10. 93 ＋4. 68 Hz; t =2. 311, P =0. 024） and sides of infarction （X2 =4. 737, P =0. 030） between the long-term good prognosis group and the poor prognosis group. Conclusion qEEG can be used as an effective of monitoring for evaluating the prognosis of patients with LMCAI.

关 键 词：脑电描记术 梗死 大脑中动脉 卒中 脑缺血 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]