失匹配负性电位联合脑电功率谱峰频率ABCD模型对意识障碍患者预后的预测价值  

Prognostic value of mismatch negative combined with EEG power spectrum peak frequency ABCD model in patients with consciousness disorder

作　　者：汤冉冉[1] 王鑫[2] 罗坤[1] Tang Ranran;Wang Xin;Luo Kun(Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi City,Xinjiang Uygur Autonomous Region,830000,China;Department of Critical Care Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi City,Xinjiang Uygur Autonomous Region,830000,China)

机构地区：[1]新疆医科大学第一附属医院神经外科,新疆维吾尔自治区乌鲁木齐市830000 [2]新疆医科大学第一附属医院重症医学科,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《现代电生理学杂志》2024年第1期3-7,共5页Journal of Modern Electrophysiology

摘　　要：目的探讨失匹配负性电位(MMN)联合脑电功率谱峰频率ABCD模型对重度脑损伤患者预后的预测价值。方法收集2022年6月至2023年1月入住新疆医科大学第一附属医院重症监护病房意识障碍的患者58例,于发病7 d内行事件相关诱发电位联合脑电功率谱峰频率ABCD模型检查,随访6个月,按格拉斯哥预后量表评分分组,1~2分为预后不良组,3~5分为预后良好组。分析一般资料及MMN波幅和ABCD模型与患者预后之间的关系。使用受试者工作特征曲线下面积对每个潜在的预测因子进行评估。结果纳入的58例患者中,35例患者预后良好,21例患者预后不良。单因素分析显示MMN、脑电功率谱峰频率ABCD模型与患者6个月后预后相关。而两组患者的年龄、性别、格拉斯哥昏迷评分、病因、受伤部位之间的差异无统计学意义(P>0.05)。多因素logistic回归分析显示,MMN较高波幅(OR=0.023,95%CI为0.003~0.174)是患者预后良好的独立预测因子,脑电功率谱峰频率A模型(OR=2.429,95%CI为0.236~24.992)是患者预后不良的独立预测因子。结论MMN较高波幅和脑电功率谱峰频率B、C、D模型是预测重度脑损伤患者预后良好的指标。Objective To explore the prognostic value of mismatch negative(MMN)combined with EEG power spectrum peak frequency ABCD model in patients with consciousness disorder.Methods A total of 58 patients with consciousness disorder admitted to the intensive care unit of the First Affiliated Hospital of Xinjiang Medical University from June 2022 to January 2023 were enrolled in the study.Within 7 days of onset,event related potentials combined with EEG power spectral peak frequency ABCD model examination were performed.They were followed up for 6 months and divided into poor prognosis group and good prognosis group according to the Glasgow outcome scale.The relationship between general data,MMN amplitude and ABCD model and patient prognosis was analyzed.Each potential predictor was evaluated using the area under the curve of receiver operating characteristic.Results Of the 58 patients included,35 cases had a good prognosis and 21 cases had a poor prognosis.Univariate analysis showed that MMN and EEG power spectrum peak frequency ABCD models were related to the prognosis of patients after 6 months.There was no significant difference in age,gender,Glasgow coma scale,etiology and injury site between the two groups(P>0.05).Multivariate logistic regression analysis showed that high MMN amplitude(OR=0.023,95%CI 0.003-0.174)was an independent predictor of good prognosis,and EEG power spectrum peak frequency A model(OR=2.429,95%CI 0.236-24.992)was an independent predictor of poor prognosis.Conclusion High MMN amplitude and EEG power spectrum peak frequency B,C,D models are indicators for predicting the good prognosis of patients with severe brain injury.

关 键 词：意识障碍 事件相关电位 脑电描记术 预后 

分 类 号：R651.15[医药卫生—外科学]