颅内电极脑电图在病毒性脑炎非惊厥性癫痫持续状态中的应用价值  

The Value of Intracranial Electroencephalogram in the Treatment of Viral Encephalitis with Non-Convulsive Status Epilepticus

作　　者：徐则林 李晓黎 刘畅[1] 寇思宇 余沛勋 Xu Zelin;Li Xiaoli;Liu Chang;Kou Siyu;Yu Peixun(Department of Brain Electrical,the Fourth Affiliated Hospital of Harbn Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第四医院脑电室,150000

出　　处：《生命科学仪器》2018年第3期49-53,共5页Life Science Instruments

基　　金：黑龙江省卫生厅基金项目(2016-129)

摘　　要：目的研究颅内电极脑电图监测技术在病毒性脑炎非惊厥性癫痫持续状态应用价值并予以分析。方法选取2015年4月~2017年10月于我院接受治疗的病毒性脑炎患者110例为研究对象。分别对所有患者进行常规脑电图监测、颅内电极脑电图监测以及脑脊液检查。分别比较两组脑电图异常率情况以及癫痫样放电现象发生率情况。此外,根据患者是否为非惊厥性癫痫持续状态分非惊厥性癫痫持续状态40例,惊厥性癫痫持续状态70例。以脑脊液检查为金标准:分析两种检测方式诊断病毒性脑炎非惊厥性癫痫持续状态的敏感度、特异性以及准确度。结果颅内电极脑电图监测病毒性脑炎的脑电图轻度异常率为0.00%(0/110),明显低于常规脑电图组的10.91%(12/110),而脑电图重度异常率与癫痫样放电现象发生率分别为46.36%(51/110)、56.36%(62/110),均明显高于常规电脑组的25.45%(28/110)、16.36%(18/110),组间对比差异有统计学意义(均P<0.05)。常规脑电图监测诊断病毒性脑炎非惊厥性癫痫持续状态的真阳性以及真阴性人数占比均明显低于颅内电极脑电图监测,组间对比差异均有统计学意义(均P<0.05)。以脑脊液检查为金标准,常规脑电图诊断病毒性脑炎非惊厥性癫痫持续状态的灵敏度、特异性以及准确性分别为57.50%、60.00%、59.09%,均明显低于颅内电极脑电图监测的85.00%、84.29%、84.55%,组间对比差异有统计学意义(均P<0.05)。结论颅内电极脑电图监测技术应用于病毒性脑炎非惊厥性癫痫持续状态诊断中具有较高的价值,有利于为临床治疗方案的制定提供参考依据,同时可作为临床治疗预后的指标,值得临床应用。Objective To explore the clinical application value of intracranial electroencephalogram（EEG） monitoring technology in the treatment of viral encephalitis with non-convulsive status epilepticus. Methods 110 cases of patients with viral encephalitis were selected as the study subjects, who received treatment in our hospital from April 2015 to October 2017. Routine electroencephalogram monitoring, intracranial electroencephalogram monitoring and cerebrospinal fluid examination were performed for all patients. We compared the abnormal rate of electroencephalogram and recorded the incidence of epileptic discharge. In addition, the cases were divided into two groups according to the types of status epilepticus as 40 non-convulsive cases and 70 convulsive cases. Taking cerebrospinal fluid（CSF） examinations as gold standards, the sensitivity, specificity and accuracy in diagnosing the non-convulsive status epilepticus of viral encephalitis were compared between two detection methods. ResultsThe mildly abnormal rate of intracranial EEG（0.00%,0/100） was significantly lower than that of routine EEG（10.91%,12/110）. However, the severely abnormal rate（46.36% 51/110） and the incidence of epileptic discharge（56.36%,62/110） were both significantly higher than that of routine EGG（ 25.45%,28/110;16.36%（18/110）.The true positive and true negative rates of routineEGG for the detection of the non-convulsive status epilepticus of viral encephalitis were significantly lower than that of intracranial EGG. According to the gold standars of cerebrospinal fluid（CSF） examinations, the sensitivity, specificity and accuracy in diagnosing the non-convulsive status epilepticus of viral encephalitis were 57.50%, 60.00% and 59.09% in the routine EGG group respectively,which were significantly lower than that in the intracranial EGG group（85.00%, 84.29% and 84.55% respectively）. These differences between the two groups were statistically significant（P〈0.05）. Conclusion Intracranial EGG monitoring techno

关 键 词：病毒性脑炎 非惊厥性癫痫持续状态 颅内电极脑电图 脑电图异常 

分 类 号：R512.3[医药卫生—内科学]