振幅整合脑电图在新生儿急性胆红素脑病诊断和预后评估中的价值

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摘要目的探讨新生儿急性胆红素脑病(ABE)振幅整合脑电图的特点及在诊断和预后评估中的价值。方法在玉林3家医院住院诊断为ABE的患儿80例进行aEEG监测,将监测结果与脑干听觉诱发电位、头颅MRI及随访结果比较。结果警告期、痉挛期分别占27.5%和72.5%;警告期中aEEG正常、轻度异常和重度异常分别占18.2%、68.2%和13.6%;痉挛期中无正常aEEG;轻度、重度异常占5.2%和94.8%。aEEG结果与临床分期正相关(K=0.62)。警告期BAEP检查正常、轻度异常、中度异常、重度异常分别为22.7%、54.5%、18.2%、4.5%;痉挛期中度异常和重度异常分别占17.2%和82.8%。脑功能监测结果与BAEP分级正相关(K=0.57)。aEEG正常的患儿在6月龄时INFANIB评分均正常;aEEG轻度异常中正常和过度分别为80.0%和20.0%;aEEG重度异常中正常和过度分别为33.3%和66.7%。痉挛期aEEG轻度异常中失访和过度分别为33.3%和66.7%;aEEG重度异常中电静止患儿6月龄时均死亡,过度和异常分别为38.2%和56.4%。结论振幅整合脑电图可用于新生儿胆红素脑病早期诊断及神经学预后评估。

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关键词 ：振幅整合脑电图, 脑功能监测, 新生儿, 急性胆红素脑病

Abstract：Objective To characterize neonatal acute bilirubin encephalopathy (ABE) amplitude -integrated electroencephalography (aEEG) and to assess the value in the diagnosis and prognosis.Methods Eighty cases of children diagnosed as ABE with aEEG monitoring at three hospital were included. The results were compared with brainstem auditory evoked potential, cranial magnetic resonance imaging (MRI), and follow-up results.Results Warning period and cramps period accounted for 27.5% and 72.5%, respectively. aEEG normal, mild and severe abnormal accounted for 18.2%, 68.2% and 68.2%, respectively in warning period. Spasm midterm had no normal aEEG, and mild and severe abnormal accounted for 5.2% and 94.8%, respectively. The aEEG results were positively correlated with clinical stages (K=0.62). Warning period abnormal BAEP examination normal, mild, moderate, severe abnormality were 22.7%, 54.5%, 18.2%, 54.5%, respectively. Spasm stage of moderate and severe abnormal accounted for 17.2% and 82.8%, respectively. Brain function monitoring results were positively correlated with BAEP classification (K=0.57). aEEG normal infant score at 6 months was normal; aEEG mildly abnormal in normal and excessive were 80.0% and 20.0%, respectively; severely abnormal aEEG in normal and excessive were 33.3% and 66.7%, respectively. Severely abnormal aEEG static electricity of children age 6 months were dead; excessive and anomalies were 38.2% and 56.4%, respectively.Conclusion Amplitude-integrated electroencephalography can be used in neonatal bilirubin encephalopathy in the early diagnosis and prognosis assessment.

Key words： Amplitude-integrated electroencephalography Brain function monitoring Neonatal Acute bilirubin encephalopathy

收稿日期: 2014-01-01

基金资助:玉林市科技攻关(玉林科攻13070041)

引用本文:

段玉会, 王洲洪, 梁武华, 韦巧珍, 苏萍, 徐芝兰. 振幅整合脑电图在新生儿急性胆红素脑病诊断和预后评估中的价值[J]. 中国生育健康杂志, 2014, 25(5): 405-408.
Department of Neonatology, Yulin First People’s Hospital, Yulin 537000, China. Clinical value of amplitude-integrated electroencephalography in the diagnosis and prognosis of neonatal acute bilirubin encephalopathy. Chinese Journal of Reproductive Health, 2014, 25(5): 405-408.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2014/V25/I5/405

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