脑电双频指数评估弥散性轴索损伤患者脑损伤及预后的临床研究  

Value of bispectrai index in evaluating brain injury and prognosis in patients with diffuse axonal injury

作　　者：陈建军 司林杰 姚洁 陈兰平 邓义军 陆士奇[2] 

机构地区：[1]盐城市第一人民医院重症医学科,江苏盐城224000 [2]苏州大学附属第一医院急诊科,江苏苏州215006

出　　处：《中国急救医学》2017年第5期458-461,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨弥漫性轴索损伤（diffuse axonal injury，DAI）患者脑电双频谱指数（bispectral index，BIS）与格拉斯哥昏迷评分（glasgow comas cale，GCS）、血清神经元特异性烯醇化酶（neuFOrt—specificenolase，NSE）和S100蛋白浓度的相关性及其在脑损伤和预后方面的评估价值。方法选取2016—01～2016—09间盐城市第一人民医院ICU收治的47例DAI患者，人院3d内或停用镇静剂24h后行BIS监测，同时进行GCS评分、血清NSE和S100蛋白水平检测，随访观察3个月的预后。分析BIS值与GCS评分、血清NSE和S100蛋白水平的相关性，比较不同BIS值之间GCS评分、血清NSE和S100蛋白水平的差异。比较预后良好与不良组之间BIS值、GCS坪分、血清NSE和S100蛋白水平的统计学差异。结果B1S值与GCS评分呈正相关（r=0．626，P〈0．001），与帆清NSE和S100均呈负相关（r=-0．607，P〈0．001；r=-0．680，P〈0．001）。不同的BIS值之间，GCS评分、血清NSE和S100浓度差异均有统计学意义（均P〈0．001）。预后良好不和不良组B1S值、GCS评分、血清NSE和S100浓度差异均有统计学意义（均P〈0．001）。结论BIS监测具有无创、直观、易于操作、可连续监测的特点，可以作为判断DAI患者腑损伤和预后的早期客观指标。Objective To investigate the effect of bispectral index （BIS） on the brain injury and prognosis in patients with diffuse axonal injury （DAD. Methods There are totally 47 patients who were admitted in the First People＇ s Hospital of Yancheng from January 2016 to september 2016. The BIS was continuously monitored for 12 h within the first 3 days after admission to hospital or 24 hours ＇after stoppage of sedative. At the same time, the glasgow coma scale （GCS）was evaluated, the serum levels of NSE and S100 protein were determined, and the patients were followed up for three months. The correlations among BIS, GCS, NSE and SI00, as well as the differences in GCS, NSE and S100 between dill）rent BIS groups were analyzed. The differences in BIS, GCS, NSE and S100 were compared between the poor and good prognosis groups. Results BIS was positively correlated with GCS （r = 0. 626, P 〈 0. 0014） , whereas negatively correlated with NSE and S100 （r = -0. 607, P 〈 0. 001 ; r = -0. 680, P 〈0. 001 ）. GCS, NSE and S100 had significant differences in different BIS groups （all P 〈0. 001 ）.Moreover, BIS, GCS, NSE and S100 were significantly different between patients with poor and good prognosis. Conclusion BIS is non - intrusive, easy to operate and allows for continuous monitoring. It is an objective index beneficial for early stage evaluation and prognosis of DAI.

关 键 词：弥漫性轴索损伤(DAI) 脑电双频谱指数(BIS) 血清神经元特异性烯醇化酶(NSE) S100蛋白 格拉斯哥昏迷评分(GCS) 预后 

分 类 号：R734.204[医药卫生—肿瘤]