脑电图联合血清BNP、NSE预测病毒性脑炎患儿预后的价值  

Value of Electroencephalography Combined with Serum BNP and NSE in Predicting the Prognosis of Children with Viral Encephalitis

作　　者：李怡静 庞素玲 石宏 蔡慧敏 于俊霞 王松江 LI Yijing;PANG Suling;SHI Hong;CAI Huimin;YU Junxia;WANG Songjiang(Department of Pediatrics,Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院儿科,河南开封475000

出　　处：《河南医学研究》2024年第16期3003-3007,共5页Henan Medical Research

摘　　要：目的探究脑电图联合血清脑钠肽(BNP)、神经元特异性烯醇化酶(NSE)对病毒性脑炎患儿预后的预测价值。方法选取2021年4月至2023年6月开封市中心医院收治的89例病毒性脑炎患儿进行研究。根据儿童格拉斯哥预后量表对患儿预后进行分组,预后良好组(4~5级)29例,预后不良组(1~3级)60例。比较患儿临床资料、血清BNP、NSE水平及脑电图情况,分析影响病毒性脑炎患儿预后的因素,比较单独及联合预测病毒性脑炎患儿预后的价值。结果预后不良组脑电图异常率及血清BNP、NSE水平高于预后良好组(P<0.05)。预后不良组惊厥持续状态占比高于预后良好组(P<0.05)。多因素logistic回归分析显示,脑电图中度异常和重度异常、血清BNP、血清NSE、惊厥持续状态是病毒性脑炎患儿预后的危险因素(P<0.05)。脑电图及血清BNP、NSE联合预测患儿预后的曲线下面积(AUC)为0.971,灵敏度为98.30%,特异度为93.10%,大于单项检测。结论脑电图中度异常和重度异常、血清BNP、NSE是病毒性脑炎患儿预后的危险因素,联合评估对其预后预测价值比单一评估更高。Objective To explore the clinical value of electroencephalography(EEG)combined with serum natriuretic peptide(BNP)and neuron-specific enolase(NSE)in the prognosis of children with viral encephalitis.Methods A total of 89 children with viral encephalitis admitted to Kaifeng Central Hospital from April 2021 to June 2023 were selected for the study.According to the Glasgow prognostic scale,the prognosis of the children was grouped,and there were 29 cases in the good prognosis group(grade 4-5)and 60 cases in the poor prognosis group(grade 1-3).The clinical data,serum BNP,NSE examination and electroencephalogram were compared,the influencing factors affecting the prognosis of children with viral encephalitis were analyzed,and the value of alone and combined in predicting the prognosis in children with viral encephalitis was compared.Results The abnormal rate of EEG and serum BNP and NSE levels in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The proportion of status convulses in the poor prognosis group was higher than that in the good prognosis group(P<0.05).Multivariate logistic regression showed that moderate and severe abnormalities in EEG,serum BNP,serum NSE and status convulsive status were risk factors for the prognosis of children with viral encephalitis(P<0.05).The area under the curve(AUC)of EEG,NSE and BNP was 0.971,sensitivity was 98.30%and specificity was 93.10%,which was greater than the single test.Conclusion Moderate and severe abnormalities in EEG,serum BNP and NSE are risk factors for the prognosis of children with viral encephalitis,and the prognostic value of combined assessment is higher than that of single assessment.

关 键 词：脑电图 脑钠肽 神经特异性烯醇化酶 病毒性脑炎 儿童 预后 

分 类 号：R742[医药卫生—神经病学与精神病学]