振幅整合脑电图对心肺复苏患儿脑功能早期预后的价值  

Value of amplitude integrated electroencephalogram in early prognosis of brain function in children underwent cardiopulmonary resuscitation

作　　者：刘义 王文辉 潘慧茹 SYED IKRAM-UL-HASSAN 高科 赵武[1] LIU Yi(The first affiliated hospital of Bengbu medical college,Bengbu,Anhui,233004,China.)

机构地区：[1]蚌埠医学院第一附属医院儿科,安徽蚌埠233004 [2]阜南县人民医院儿科,安徽阜南236300 [3]灵璧县人民医院儿科,安徽灵璧234200

出　　处：《齐齐哈尔医学院学报》2020年第10期1210-1213,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨振幅整合脑电图(aEEG)在心肺复苏(CPR)患儿早期预后评估中的价值。方法选择2017年3月—2019年5月本院儿童重症监护室(PICU)收治的CPR患儿32例进行aEEG及同步视频脑电图(vEEG)监测,包括患儿复苏时长、住院时间及儿童改良格拉斯哥昏迷评分(GCS)。根据发病后3个月脑功能评分量表(PCPC)分为预后良好组(1~3分)和预后不良组(4~6分)。用Spearman秩相关分析aEEG与vEEG及改良GCS评分的相关性;用受试者工作特征曲线(ROC)评价aEEG、vEEG及改良GCS对脑功能早期预后的价值。结果两组不同预后患儿之间年龄、性别、住院时间差异均无统计学意义(P>0.05),复苏时长、aEEG分级、vEEG分级与改良GCS评分差异有统计学意义(P<0.05);Spearman秩相关分析显示aEEG与vEEG及改良GCS均呈正相关(r值分别为0.630及0.576,均P<0.001);ROC曲线分析显示aEEG预测CPR患儿脑功能预后的ROC曲线下面积(AUC)=0.901,最佳截断值为1.5时,灵敏度为0.958,特异度为0.625,vEEG的AUC=0.880,最佳截断值为3.5时,灵敏度为0.833,特异度为0.875;改良GCS的AUC=0.779,最佳截断值为2.5时,灵敏度为0.833,特异度为0.625。结论 aEEG不仅能用于CPR患儿早期预后评估,而且比vEEG和改良GCS预测价值更高。Objective To explore the value of amplitude integrated electroencephalogram(aEEG) in evaluating early prognosis of children received cardiopulmonary resuscitation(CPR)Methods A total of 32 patients those were treated with CPR in pediatric intensive care unit(PICU) our hospitalwere monitored by aEEG and synchronous video electroencephalogram(vEEG), including resuscitation duration, length of hospital stay, and modified Glasgow coma score(GCS).According to score of the brain function score scale 3 months after the onset of the disease, the patients were divided into the group with good prognosis(PCPC1~3 points) and the group with poor prognosis(4~6 points).Spearman rank correlation was used to analyze the correlation between aEEG, vEEG and improved GCS score.The value of aEEG, vEEG and modified GCS in early prognosis of brain function was evaluated by receiver operating characteristic curve(ROC).Results There were no statistically significant differences in age, gender and length of hospital stay between the two groups with different prognosis(all P>0.05),and there were statistically significant differences in resuscitation duration, aEEG classification, vEEG classification and modified GCS score(P<0.05).Spearman rank correlation analysis showed that aEEG was positively correlated with vEEG and improved GCS(r values were 0.630 and 0.576, respectively,P<0.001).ROC curve analysis showed that the area under ROC curve(AUC) of aEEG in predicting the prognosis of cerebral function in children with CPR was 0.901, the sensitivity was 0.958 and the specificity was 0.625 and the optimal cut-off value was 1.5, the AUC of vEEG was 0.880, the sensitivity was 0.833 and the specificity was 0.875 and the optimal cut-off value was 3.5.When the AUC of the modified GCS was 0.779 and the optimal cut-off value was 2.5, the sensitivity was 0.833 and the specificity was 0.625.Conclusions aEEG could not only be used to evaluate the early prognosis of children with CPR, but also has higher predictive value than vEEG and modified GCS.

关 键 词：振幅整合脑电图 心肺复苏 预后 

分 类 号：R459.7[医药卫生—急诊医学]