振幅整合脑电图联合脑电监测α波变异百分率评估重症急性脑梗死患者短期预后的价值  

Predictive value of amplitude integrated electroencephalogram combined with EEG monitoring PAV for short-term prognosis of patients with SACI

作　　者：刘杰 彭旭 谭红 张丹 姜波涛 Liu Jie;Peng Xu;Tan Hong;Zhang Dan;Jiang Botao(Neurosurgical Intensive Care Unit,Changsha First Hospital,Changsha 410005,Hunan Province,China)

机构地区：[1]长沙市第一医院神经内科重症监护室,410005

出　　处：《中华老年心脑血管病杂志》2023年第10期1070-1073,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：湖南省卫生健康委科研计划项目(D202303076967)。

摘　　要：目的探讨振幅整合脑电图(aEEG)联合脑电监测α波变异百分率(PAV)评估重症急性脑梗死(ACI)患者短期预后的价值。方法选择2020年1月至2022年12月长沙市第一医院神经内科重症监护室住院的重症ACI患者212例,根据90d时改良的Rankin量表评分分为预后不良组93例和预后良好组119例。观察2组aEEG和PAV差异,采用多因素logistic回归分析aEEG和PAV与预后不良的关系,采用ROC曲线分析aEEG和PAV预测重症ACI患者预后的临床价值。结果212患者90d时预后不良发生率43.9%。预后不良组aEEG评分明显高于预后良好组,PAV明显低于预后良好组,差异有统计学意义(P<0.01)。多因素logistic回归分析显示,aEEG是预后不良的风险因素(OR=1.403,95%CI:1.114~3.287,P=0.011),PAV是预后不良的保护因素(OR=0.714,95%CI:0.591~0.837,P=0.006)。ROC曲线分析显示,PAV预测重症ACI预后不良的敏感性、特异性、曲线下面积(AUC)均高于aEEG。aEEG+PAV联合预测重症ACI预后不良的敏感性、特异性、AUC均高于aEEG和PAV单独检测(P<0.01)。结论aEEG和PAV联合应用对预测重症ACI患者的预后具有较高临床价值。Objective To explore the value of amplitude integrated electroencephalogram(aEEG)combined with electroencephalogram monitoringαpercentage variation(PAV)in evaluating the short-term prognosis of patients with severe acute cerebral infarction(SACI).Methods A total of 212 SACI patients hospitalized in our ICU from January 2020 to December 2022 were recruited and then divided into poor prognosis group(93 cases)and good prognosis group(119 cases)according to the mRS score at 90 d.The differences in aEEG and PAV were observed between the two groups.Multivariate logistic regression analysis was used to observe the relationship of aEEG and PAV with poor prognosis.ROC curve was plotted to analyze the clinical value of aEEG and PAV in predicting the prognosis of SACI patients.Results The incidence of poor prognosis was 43.9%in 212 patients at the 90th day.The patients from the poor prognosis group had significantly higher aEEG score but lower PAV than those in the good prognosis group(P<0.01).Multivariate logistic regression analysis showed that aEEG was a risk factor for poor prognosis(OR=1.403,95%CI:1.114-3.287,P=0.011),and PAV was a protective factor for poor prognosis(OR=0.714,95%CI:0.591-0.837,P=0.006).ROC curve results revealed that PAV had a higher sensitivity,specificity and AUC value than aEEG in predicting poor prognosis of SACI patients,and their combination obtained better sensitivity,specificity and AUC value than aEEG or PAV alone in the prediction(P<0.01).Conclusion The combined use of aEEG and PAV has high clinical value in predicting the prognosis of SACI patients.

关 键 词：脑梗死 脑电描记术 预后 α波变异百分率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]