脑电图联合脑CT灌注成像评定动脉瘤性蛛网膜下腔出血患者预后的价值  

Value of EEG combined with CT perfusion imaging in prognosis of patients with aneurysmal subarachnoid hemorrhage

作　　者：王淇民 杨璇 高飞[1] WANG Qimin;YANG Xuan;GAO Fei(Nanyang Second People’s Hospital,Nanyang 473012,China)

机构地区：[1]南阳市第二人民医院,河南南阳473012

出　　处：《中国实用神经疾病杂志》2021年第12期1061-1066,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191471)。

摘　　要：目的探讨动脉瘤性蛛网膜下腔出血(aSAH)患者预后评定中脑电图(EEG)联合脑CT灌注成像(CTP)的作用。方法纳入2019-06—2021-01南阳市第二人民医院aSAH住院患者60例,脑电图联合脑CT灌注成像检查组(联合检查组)30例,单独脑CT灌注成像检查组(单独检查组)30例,分析联合检查组患者的动态EEG Young分级,分析2组患者的脑血管痉挛、痫样发作检出情况及发生与未发生脑血管痉挛患者的CTP参数、mRS评分。结果联合检查组动态EEG Young分级Ⅰ级2例(6.7%),Ⅱ级4例(13.3%),Ⅲ级14例(46.7%),Ⅳ级8例(26.7%),Ⅴ级2例(6.7%)。60例患者中脑血管痉挛、痫样发作检出率分别为46.7%(28/60)、40.0%(24/60),其中联合检查组患者的脑血管痉挛、痫样发作检出率分别为73.3%(22/30)、60.0%(18/30),均显著高于单独检查组的20.0%(6/30)、20.0%(6/30),差异有统计学意义(P<0.05)。2组脑血管痉挛患者的CBF、CBV均显著低于未发生脑血管痉挛者(P<0.05),TTP、MTT均显著高于未发生脑血管痉挛患者(P<0.05)。2组发生脑血管痉挛患者的mRS评分[(3.6±1.1)分]显著高于未发生脑血管痉挛者[(1.1±0.3)分](P<0.05)。结论动脉瘤性蛛网膜下腔出血患者预后评定中脑电图联合脑CT灌注成像的价值较单独脑CT灌注成像检查高。Objective To explore the application of electroencephalogram combined with cerebral CT perfusion imaging in prognosis evaluation of patients with aneurysmal subarachnoid hemorrhage.Methods Sixty cases of patients with SAH in our hospital from June 2019 to January 2021 were retrospectively selected and divided into EEG combined with CT Perfusion imaging group(joint examination group,n=30)and single brain CT perfusion imaging examination group(single examination group,n=30).The dynamic EEG of patients in the joint examination group was analyzed.The detection of cerebral vasospasm and epileptic seizures,CTP parameters and mRS scores of patients with and without cerebral vasospasm were statistically analyzed.Results In the combined examination group,2 cases(6.7%)with dynamic EEG young classification,4 cases(13.3%)with gradeⅡ,14 cases(46.7%)with gradeⅢ,8 cases(26.7%)with gradeⅣand 2 cases(6.7%)with gradeⅤ.The detection rates of cerebral vasospasm and epileptiform attack in the two groups were 46.7%(28/60)and 40.0%(24/60),respectively.The detection rates of cerebral vasospasm and epileptic attack in the combined examination group were 73.3%(22/30)and 60.0%(18/30),respectively,which were significantly higher than the single examination group 20.0%(6/30)and 20.0%(6/30),P<0.05.The CBF and CBV of patients with cerebral vasospasm were significantly lower than patients without cerebral vasospasm(P<0.05),the TTP and MTT were significantly higher than patients without cerebral vasospasm(P<0.05).The mRS score of patients with cerebral vasospasm(3.6±1.1)was significantly higher than patients without cerebral vasospasm(1.1±0.3)(P<0.05).Conclusion The value of EEG combined with CT perfusion imaging in prognosis evaluation of patients with aneurysmal subarachnoid hemorrhage is higher than CT perfusion imaging alone.

关 键 词：动脉瘤性蛛网膜下腔出血 预后 脑电图 脑CT灌注成像 脑血管痉挛 痫样发作 mRS评分 

分 类 号：R743.34[医药卫生—神经病学与精神病学]