新生儿低血糖脑损伤振幅整合脑电图特征研究  

Characteristics of amplitude integrated EEG in neonates with hypoglycemic brain damage

作　　者：郭志梅[1] 刘芳[1] 周春风[1] 暴丽莎[1] 吕少广[1] 杜志方[1] 

机构地区：[1]白求恩国际和平医院儿科NICU,河北石家庄050000

出　　处：《临床儿科杂志》2013年第11期1019-1023,共5页Journal of Clinical Pediatrics

基　　金：河北省科技攻关课题(No.072761185)

摘　　要：目的探讨新生儿低血糖脑损伤的临床特征,研究低血糖脑损伤时振幅整合脑电图(aEEG)的变化特点,探讨aEEG在低血糖脑损伤时的预测作用。方法选取24例低血糖新生儿,在诊断低血糖当天行MRI检查,当天或隔天行aEEG描记,分析aEEG背景波的变异性、睡眠-觉醒周期、下边界及振幅等变化特点,并与MRI结果比较。结果严重低血糖脑损伤新生儿出现不同程度的癫发作,并在血糖纠正后继续存在。低血糖脑损伤时aEEG的表现为帽状或锯齿形癫发作,睡眠-觉醒周期消失,而对下边界及振幅的影响不大。睡眠-觉醒周期恢复提示脑功能恢复良好。在监测低血糖脑损伤方面,aEEG与MRI有很好的一致性。结论 aEEG在监测低血糖脑损伤时有其特征意义的变化,可用来动态监测低血糖脑损伤。Objectives To investigate the clinical characteristics of hypoglycemic brain damage, and to assess the ifndings of amplitude-integrated electroencephalography （aEEG） and its predictive value in hypoglycemic brain damage. Methods Twenty-four neonates diagnosed with hypoglycaemia were selected. 12-hour continuous aEEG recordings were performed on the day when hypoglycaemia was diagnosed and second aEEG tracings was performed on the same day or the day after. The variability of aEEG background, appearance of sleep-wake cycling, bandwidth span and amplitude of lower border were analysed and compared with the results of brain MRI. Results Different degrees of epileptic seizures were found in neonates with severe hypoglycemic brain damage and were persisted after the blood sugar was corrected. aEEG in hypoglycemic brain damage was characterized by calyptriform or jagged epileptiform activity, disappearance of the sleep-wake cycle, but little impact on amplitude of lower border and bandwidth span. The recovery of sleep-wake cycle was a sign of brain function recovery. The aEEG and MRI had a good consistency in monitoring the hypoglycemic brain damage. Conclusions aEEG have signiifcant changes in hypoglycemic brain damage and can be used to monitor dynamically hypo-glycemic brain damage.

关 键 词：低血糖脑损伤 振幅整合脑电图 磁共振成像 新生儿 

分 类 号：R722.1[医药卫生—儿科]