急性心源性大面积脑梗死患者定量脑电图参数与预后的相关性分析  

Correlation analysis between quantitative EEG parameters and clincal prognosis in patients with acute cardiogenic large area cerebral infarction

作　　者：莫延红 王长玉 孔朝红[1] 张兆辉[1] Mo Yanhong;Wang Changyu;Kong Chaohong(Department of Neurology,Renmin Hospital of Wuhan University,Wuhan 430060)

机构地区：[1]武汉大学人民医院神经内科,430060

出　　处：《卒中与神经疾病》2020年第3期316-322,共7页Stroke and Nervous Diseases

基　　金：国家自然基金项目(No.81671051)资助;2018年度院二类新技术新业务项目(2018-017)。

摘　　要：目的评估急性心源性大面积脑梗死(Acute cardiogenic massive cerebral infarction, ACMCI)患者定量脑电图(Quantitative Electroencephalogram,QEEG)参数与临床预后的相关性。方法选取2018年11月-2019年4月入住本院神经重症监护室19例ACMCI患者,在入院48 h内进行持续脑电监测并记录平均δ、θ、α、β、pd-BSI等指标采用Spearman方法评估定量脑电图参数与临床预后的相关性。结果 (1)在全头部尤其前头部区域δ波、θ波、DTABR(δ+θ)/(α+β)比值与入院1周(尤其发病48 h内)的NIHSS评分呈显著正相关(r=0.738、0.688、0.707,P<0.05),与临床预后呈显著负相关(r=-0.518、-0.539、-0.516,P<0.05);ABDTR与与预后呈显著正相关(r=0.516,P=0.031);(2)前头部区域(α+β+θ)/δ比值、后枕部区域(θ+β+δ)/α比值与入院1周以内NIHSS评分呈显著负相关,与预后呈显著正相关(r=0.522、0.522,P=0.021、0.039);(3)在后枕部区域βI/C比值与预后呈显著负相关(r=-0.648,P=0.017),而(β+θ)I/C、(β+α)I/C、(α+β+θ)I/C比值呈显著正相关(r=0.606、0.663、0.506,P=0.010、0.013、0.046);(4)在全导联脑对称参数pd-BSI与入院1周内呈显著负相关(r=-0.477,P=0.045)。结论在入院1周以内前头部区域δ波、θ波、DTABR、(α+β+θ)/δ比值有明显变化,在后枕部区域(θ+β+δ)/α、βI/C比值以及pd-BSI也有明显变化,尤其入院48 h内的变化会影响患者的预后,建议早期行重症脑电监测,尽早评估患者情况及尽早干预治疗,降低病死率。Objective To evaluate the association between Quantitative Electroencephalogram(QEEG) parameters and clinical prognosis in patients with acute cardiogenic massive cerebral infarction(ACMCI). Methods The clinical data of hospitalized 19 ACMCI patients in the neurological intensive care unit(NICU) of our hospital, from November 2018 to April 2019 were collected and analyzed. Then we recorded average δ, θ, α, β,(θ+δ)/(α+β) ratio(DTABR), pd-BSI etc, and assessed the correlation between parameters and clinical outcome by Spearman in 48 hours.Results(1) In the whole head, especially in the anterior head region, the delta wave, theta wave, and the DTABR ratio were significantly positively correlated with the NIHSS score within 1 week of admission(especially within 48 hours of onset), and were significantly negatively correlated with clinical outcome(P<0.05), ABDTR was positively correlated with prognosis(r=0.516,P=0.031).(2) The anterior head, region(α+β+θ)/δratio and the posterior occipital region(θ+β+δ)/αratio were significantly negatively correlated with the NIHSS score within 1 week of admission, and was a significant positive correlation with prognosis(r=0.522,0.522,respectively, P=0.021,0.039).(3) In the posterior occipital region, the β I/Cratio was significantly negatively correlated with prognosis(r=-0.648, P=0.017), while(β+θ)I/C,(β+α)I/C,(α+ The β+θ)I/C ratio were a significant positive correlation(r=0.606,0.663,0.506, respectively, P=0.010,0.013,0.046).(4) In the whole lead, the brain symmetry parameter pd-BSI was significantly negatively correlated with admission within 1 week(r=-0.477, P<0.017).Conclusion The changes of δ wave, θwave, DTABR and(α+β+θ)/δratio in the anterior head region within 1 week after admission, and(θ+β+δ)/α, β I/C ratioChanges and differences of pd-BSI in the posterior occipital region, especially within 48 hours of admission, mihgt affect the patient’s prognosis. We recommended to perform early severe EEG monitoring, early assessment of the patien

关 键 词：急性心源性大面积脑梗死 定量脑电图QEEG 参数 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]