振幅整合脑电图对早产儿脑损伤的诊断价值及其影响因素  

Diagnostic value and influencing factors for amplitude-integrated EEG in brain injury in preterm infants

作　　者：刘茜[1] 王永芹[2] 张永峰[2] 赵月华[2] 朱海玲[2] 孙蕊蕊[1] 刘培莉[1] 刘小晓[1] 李金洁[1] 

机构地区：[1]潍坊医学院儿科学教研室,山东潍坊261042 [2]潍坊医学院附属医院儿二科,山东潍坊261031

出　　处：《中国当代儿科杂志》2015年第5期435-439,共5页Chinese Journal of Contemporary Pediatrics

摘　　要：目的：探讨振幅整合脑电图（aEEG）对早产儿脑损伤（BIPI）的诊断价值及其影响因素。方法将116例胎龄27-36＋6周早产儿纳入研究，对所有早产儿生后 6 h 内aEEG进行评分；依据BIPI诊断结果将116例早产儿分为BIPI组（n=63）和非BIPI组（n=53），采用logistic回归分析对导致BIPI发生的危险因素进行评估；依据aEEG检测结果再将116例早产儿分为aEEG正常组（n=58）和aEEG异常组（n=58），对影响早产儿aEEG结果的因素行单因素分析。结果 BIPI组中aEEG异常52 例（83%）；非BIPI组中aEEG 异常6例（11%），两组aEEG异常率比较差异有统计学意义（P〈0.05）。将早产儿依据胎龄27-33＋6周和34-36＋6周进行划分，BIPI组aEEG评分明显低于同胎龄非BIPI组（P〈0.01）。Logistic回归分析显示：小胎龄（〈32周）、低出生体重（〈1 500 g）、胎盘胎膜及脐带异常和母孕期高血压是导致BIPI发生的高危因素（P〈0.05）。aEEG异常组与aEEG正常组在胎龄、出生体重、胎盘胎膜及脐带异常和母孕期高血压4方面比较差异有统计学意义（P〈0.05）。结论导致BIPI发生的危险因素与影响早产儿aEEG结果的因素相一致，提示aEEG有助于BIPI的早期诊断。ObjectiveTo study the diagnostic value and inlfuencing factors for amplitude-integrated EEG （aEEG） in brain injury in preterm infants.MethodsOne hundred and sixteen preterm infants with a gestational age （GA） between 27 weeks and 36＋6 weeks were enrolled as subjects. The aEEG scores of all preterm infants were obtained within 6 hours after birth. According to the diagnostic results, the 116 preterm infants were divided into two groups： brain injury （n=63） and non-brain injury （n=53）. The risk factors for brain injury were evaluated using logistic regression analysis. According to the aEEG results, the 116 preterm infants were divided into two groups： normal aEEG （n=58） and abnormal aEEG （n=58）. The influencing factors for aEEG results in preterm infants were determined using univariate analysis. ResultsThe brain injury group had a signiifcantly higher rate of abnormal aEEG than the non-brain injury group （83%vs 11%;P〈0.05）. The infants in the brain injury group from two different GA subgroups （27-33＋6 weeks and 34-36＋6 weeks） had signiifcantly lower aEEG scores than the non-brain injury group from corresponding GA subgroups （P〈0.01）. Logistic regression analysis showed that low GA （〈32 weeks）, low birth weight （〈1 500 g）, abnormal placenta, fetal membranes, and umbilical cord, and hypertension during pregnancy were high-risk factors for brain injury （P〈0.05）. There were significant differences in GA, birth weight, abnormal placenta, fetal membranes, and umbilical cord, and hypertension during pregnancy between the normal and abnormal aEEG groups （P〈0.05）.ConclusionsThe risk factors for brain injury are consistent with the influencing factors for aEEG results in preterm infants, suggesting that aEEG contributes to the early diagnosis of brain injury.

关 键 词：振幅整合脑电图 脑损伤 危险因素 早产儿 

分 类 号：R742[医药卫生—神经病学与精神病学]