BIS联合NSE用于评估脑血管疾病神经重症患者预后的初步研究  

A preliminary study of BIS combined with NSE to evaluate the prognosis of cerebrovascular disease patients with severe neurology

作　　者：费明明 李平[2] 张霖 陈剑 陶晓根 Fei Mingming;Li Ping;Zhang Lin(Department of intensive care unit, the First Affiliated Hospital of University of Science and Technology of China, Hefei 230036 ,China)

机构地区：[1]中国科技大学附属第一医院(安徽省立医院南区)重症医学科,合肥230036 [2]中国科技大学附属第一医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2018年第1期35-38,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的评价脑电双频指数(bispectral index,BIS)和神经元特异性烯醇化酶(neuron specific enolase,NSE)对脑血管疾病的重症患者预后的评估价值。方法选择收入重症医学科的脑血管病神经重症患者27例,包括自发性脑出血患者及脑梗塞患者,根据致病因素将患者分为脑出血组(18例)和脑梗塞组(9例);按BIS平均值分为<60组(21例)和≥60组(6例);根据预后将、患者分为生存组(21例)和死亡组(6例);按照性别分为男性(14例),女性(13例)。入科后予以监测0,24,48小时间期中每小时的BIS数值及患者入院后血清NSE水平,结合患者GCS评分;经积极治疗后,随访患者的转归:死亡/出院后的GOS评分,进行综合评估。结果两组患者年龄、APACHEⅡ评分、在ICU居住时间比较差异均无统计学意义(均P>0.05);脑出血组GCS、BISmean均低于脑梗塞组(P<0.05);两组血清NSE水平无明显差异(P>0.05);BIS>60组BISmean、病死率均明显高于BIS<60组(P<0.01);患者预后评价(GOS评分)两组差别不大,无统计学意义;脑出血组与脑梗塞组病死率及患者预后评价(GOS评分)无明显差异(P>0.05);BIS<60时,脑出血组与脑梗塞组病死率及患者预后评价(GOS评分)无明显差异(P>0.05)。结论脑电双频指数(BIS)可评估神经重症患者的病死率有一定意义,特别是BIS<60患者预后较差;脑出血患者的平均BIS监测值低于脑梗塞患者;神经元特异性烯醇化酶(NSE)对于脑血管疾病的重症患者预后的评估无确切价值。Objective To evaluate the value of（bispectral index,BIS）and（neuron specific enolase,NSE）,and to evaluating the prognosis of severe patients with cerebrovascular disease.Methods 27 cases of neurovascular disease in severe patients with cerebrovascular disease in the Intensive care unit,Patients with spontaneous intracerebral hemorrhage and cerebral infarction,According to the pathogenic factors,the patients were divided into cerebral hemorrhage group（18 cases）and cerebral infarction group（9 cases）;According to the average value of BIS is divided into〈60 group（21 cases）and≥60 group（6 cases）;According to the prognosis,the patients were divided into the survival group（21 cases）and the death group（6 cases）;Sex is divided into men（14 cases）,women（13 cases）.The BIS value per hour during the 0,24,48 period and the level of serum NSE after admission were monitored,combination of patients＇ GCS score;After active treatment,Prognosis of follow-up patients,A comprehensive assessment of GOS scores after death/after discharge.Results Age of two groups of patients,APACHE II score,There was no significant difference in the difference of residence time in ICU（P〉0.05）;There was no significant difference in serum NSE level between the two groups（P〉0.05）;BIS〉60 group BISmean,the fatality rate was significantly higher than that of the BIS〈60 group（P〈0.01）;The two groups of patients＇ prognostic evaluation（GOS score）were not very different,no statistical significance;There was no significant difference between the fatality rate of cerebral hemorrhage group and the cerebral infarction group and the prognosis evaluation（GOS score）（P〉0.05）;When BIS〈60,There was no significant difference between the fatality rate of cerebral hemorrhage group and the cerebral infarction group and the prognosis evaluation（GOS score）（P〉0.05）.Conclusion The bispectral index（BIS）can be used to assess the mortality of patients with severe neurological severity,the

关 键 词：脑电双频指数 神经元特异性烯醇化酶 脑出血 脑梗塞 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]