定量脑电图与病毒性脑炎预后的相关分析  

Correlation analysis between quantitative electroencephalography and prognosis of viral encephalitis

作　　者：王聪 袁旭娟 江宗华[1] WANG Cong;YUAN Xu-juan;JIANG Zong-hua(Department of Neurology,Ganzhou People's Hospital,Ganzhou,Jiangxi 341000)

机构地区：[1]赣州市人民医院神经内科,江西赣州341000

出　　处：《赣南医科大学学报》2024年第10期1023-1029,共7页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省卫生健康委员会科技计划项目(202212477)。

摘　　要：目的:分析定量脑电图(Quantitative electroencephalography,QEEG)在成人病毒性脑炎(Viral encephalitis,VE)中的运用价值,明确其对预后的预测效果。方法:收集2021年9月至2023年9月入住赣州市人民医院神经内科并符合入组标准的VE患者35例。根据是否入住ICU分为重症组(16例)和非重症组(19例),使用3个月改良Rankin评分(mRS)作为结局的评估,mRS评分≤2分为预后良好组,mRS评分≥3分为预后不良组。所有患者入院24 h内完善至少2 h脑电图检查并行QEEG功率谱分析,将大脑分为额区(F)、中央区(C)、颞区(T)、顶区(P)、枕区(O)5个区域,QEEG数据包括δ/α值(DAR)、δ+θ/α+β值(DTABR),分析重症组与非重症组、预后良好组与预后不良组的QEEG数据有无差异。结果:重症组FDAR、PDTABR及PDAR值高于非重症组,差异有统计学意义(P<0.05)。将FDAR、PDTABR及PDAR分别作为自变量,是否为重症患者作为因变量,调整有无肺炎、发病至入院时间、住院时间后,未发现QEEG数据可作为疾病严重程度的独立预测因素。预后良好组28例(80%)、预后不良组7例(20%),预后不良组有更高的FDAR、TDAR、TDTABR、CDAR、CDTABR、PDAR、PDTABR、ODAR及ODTABR值,组间比较,差异均有统计学意义(P<0.05)。将预后良好组与预后不良组有差异的QEEG数据作为自变量,长期预后作为因变量,在调整是否入住ICU、住院时间、脑脊液白介素6(Interleukin-6,IL-6)水平后发现CDAR、CDTABR可作为预后的独立预测因素,CDAR对预后的预测价值最高,截断值为7.9。结论:QEEG可作为评估VE患者预后的重要工具,病情严重、预后不佳的患者有更高程度的慢波成分。Objective:To analyse the value of quantitative electroencephalography(QEEG)in adult viral encephalitis(VE)and to clarify its predictive effect on prognosis.Methods:A total of 35 VE patients admitted to the department of neurology of Ganzhou People's Hospital(meeting the inclusion criteria)from September 2021 to September 2023 and meeting the inclusion criteria were collected.Critical(16 cases)and non-critical(19 cases)groups were categorised according to whether they were admitted to the ICU or not,and the 3-month modified Rankin Scale(mRS)was used to assess outcomes,mRS score≤2,favorable prognosis;mRS score≥3,unfavorable prognosis.Within 24 hours of hospital admission,all patients received at least 2 hours of EEG with QEEG power spectral analysis.The brain was divided into 5 regions,frontal(F),central(C),temporal(T),parietal(P)and occipital(O),the QEEG data included theδ/αvalue(DAR),δ+θ/α+βvalue(DTABR),by statistically analysing whether there was any difference in QEEG data between the critically ill and non-critically ill groups,and between the good prognosis and poor prognosis groups.Results:The values of FDAR,PDTABR and PDAR were higher in the critical group than those in the non-critical group,the difference was statistically significant(P<0.05).After adjusting for the presence or absence of pneumonia,time from onset to admission,and length of hospitalisation,with FDAR,PDTABR and PDAR as independent variables and whether or not the patient was critically ill as the dependent variable,respectively,no QEEG data were found to be an independent predictor of disease severity.There were 28 cases(88%)in the good prognosis group and 7 cases(20%)in the poor prognosis group,and the poor prognosis group had higher FDAR,TDAR,TDTABR,CDAR,CDTABR,PDAR,PDTABR,ODAR and ODTABR values,the differences were statistically significant(P<0.05)when comparing between the groups.Using the QEEG data that differed between the two groups as the independent variable and the long-term prognosis as the dependent variable,respectiv

关 键 词：定量脑电图 病毒性脑炎 预后 

分 类 号：R741.044[医药卫生—神经病学与精神病学]