脑电图对急性期脑梗死血管内介入治疗的评估价值  

Evaluation value of EEG for endovascular intervention in acute stage of cerebral infarction

作　　者：许文勇[1] 杨昌梁 叶端玲 邓丽霞 陈晓云 XU Wen-yong;YANG Chang-liang;YE Duan-ling;DENG Li-xia;CHEN Xiao-yun(Department of Neurology,Xiamen Third Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Xiamen 361100,Fujian,CHINA)

机构地区：[1]福建中医药大学附属厦门第三医院神经内科,福建厦门361100

出　　处：《海南医学》2023年第3期401-404,共4页Hainan Medical Journal

基　　金：福建中医药大学校管课题(编号:XB2019125)。

摘　　要：目的探讨脑电图对急性期前循环脑梗死血管内介入治疗效果的评估价值。方法选取2019年7月至2021年6月在福建中医药大学附属厦门第三医院行血管内介入治疗的急性期前循环脑梗死患者42例,于血管内介入治疗后24 h、3 d、7 d对其实施床旁连续脑电监测并行脑电图反应性测试,同时进行美国国立卫生研究院卒中量表(NIHSS)评分,判断预后疗效;采用Synek分级标准对血管内介入治疗后的脑电图进行分级对比分析。结果42例患者中脑电图反应性阳性31例,NIHSS改善24例(77.42%),脑电图反应性阴性11例,NIHSS改善4例(36.36%),脑电图反应性阳性者NIHSS改善率明显高于脑电图反应性阴性者,差异有统计学意义(P<0.05);脑电图Synek分级轻度异常组28例,1周NIHSS改善18例(64.29%),4周NIHSS改善22例(78.57%);脑电图Synek分级中重度异常组14例,1周NIHSS改善5例(35.71%),4周NIHSS改善6例(42.86%),脑电图轻度异常组在血管内介入治疗后第7天NIHSS改善高于脑电图中重度异常组,在血管内介入治疗后第4周NIHSS改善更明显,差异均JV有统计学意义(P<0.05)。结论脑电图反应性及Synek分级对急性期前循环脑梗死血管内介入治疗的预后具有良好的预测作用,脑电图反应性阳性者预后较好,脑电图Synek分级越低、预后越好。因此,脑电图对急性期前循环脑梗死血管内介入治疗效果有很好的评估价值。Objective To evaluate the value of EEG for endovascular intervention in acute stage of anterior circulatory cerebral infarction.Methods A total of 42 patients in acute stage of anterior circulatory cerebral infarction undergoing endovascular interventional therapy in Xiamen Third Hospital Affiliated to Fujian University of Traditional Chinese Medicine were selected from July 2019 to June 2021.EEG was performed at 24 hours,3 days,and 7 days after the intervention,and the National Institutes of Health Stroke Scale(NIHSS)score was used to determine the prognostic effect.EEG was compared according to Synek classification criteria.Results In 42 patients,EEG reactivity were positive in 31 cases,and NIHSS improved in 24 cases(77.42%);EEG reactivity was negative in 11 cases,and NIHSS improved in 4 cases(36.36%);the improvement rate of NIHSS was significantly higher in positive patients than in negative patients(P<0.05).Twenty-eight patients had mile abnormalities of EEG Synek classification,and NIHSS improved at one week in 18 cases(64.29%)and at 4 weeks in 22 cases(78.57%).Fourteen patients had moderate to severe abnormalities of EEG Synek classification,and NIHSS improved at 1 week in 5 cases(35.71%)and at 4 weeks in 6 cases(42.86%).The improvement of NIHSS was significantly higher on day 7 in group with mild EEG abnormalities than in group with moderate to severe EEG abnormalities,and more significantly at week 4 after endovascular intervention,with statistically significant difference(P<0.05).Conclusion EEG reactivity and Synek classification have good predictive effects on the prognosis of patients in acute stage of anterior circulatory cerebral infarction undergoing endovascular interventional therapy.The patients with positive EEG reactivity have better prognosis,and lower EEG Synek classification is related to better prognosis.Therefore,EEG has a significant value in evaluating the effect of endovascular intervention for anterior circulatory cerebral infarction.

关 键 词：脑电图 脑梗死 Synek分级 血管内介入 治疗效果 评估价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]