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目的通过对足月新生儿缺氧缺血性脑病(HIE)的振幅整合脑电图(aEEG)分析,结合HIE患儿Apgar评分、血气、头颅MRI检查结果,探讨aEEG早期诊断新生儿HIE的敏感性和价值,以及与病情严重程度的关系,试图为提高新生儿HIE的早期诊断率,指导有针对性的治疗提供依据。方法选择HIE足月儿74例为研究对象,分析HIE分度与aEEG严重程度分级的相关性,以及Apgar评分、血气、颅脑核磁共振(MRI)HIE分度与aEEG严重程度分级的相关性。结果 1、HIE的临床分度与aEEG异常程度存在显著相关性,aEEG判断HIE病情轻重程度的敏感性为71.7%,特异性为97.1%;2、Apgar评分分值与aEEG严重程度存在统计学意义,5分钟、10分钟Apgar评分异常的新生儿aEEG异常率高(86.9%,100%);3、生后2h内血气pH与aEEG严重程度有统计学意义;4、3-7天内MRI检查异常程度与aEEG异常程度结果密切相关。结论 aEEG是HIE患儿早期诊断及病情预测的敏感指标;生后Apgar评分分值越低,血气pH越低的患者,应作为aEEG检查高危人群;头颅MRI与aEEG都是诊断HIE敏感指标,但aEEG在时效性和便利性方面明显优于头颅MRI。
Objective To investigate the sensitivity of aEEG in early diagnosis of neonatal HIE by analyzing the amplitude integrated EEG (EEG) of full-term neonatal hypoxic-ischemic encephalopathy (HIE) and the Apgar score, blood gas and cranial MRI in HIE infants Sex and value, and the relationship with the severity of the disease, trying to improve the rate of early diagnosis of HIE in neonates, to provide guidance for targeted treatment. Methods Totally 74 children with HIE were enrolled in this study. The correlation between HIE index and severity of aEEG was analyzed. Apgar score, blood gas, MRI HIE index and aEEG severity were also analyzed. Results 1. There was a significant correlation between the clinical grade of HIE and the abnormality of aEEG. The sensitivity and the specificity of aEEG in judging the severity of HIE were 71.7% and 97.1% respectively. 2. The Apgar score and the severity of aEEG had statistical significance , Abnormal neonatal aEEG abnormalities (86.9%, 100%) in neonates with Apgar score of 5 minutes and 10 minutes; 3, the blood gas pH and the severity of aEEG within 2 hours after birth were statistically significant; 4, 3-7 days MRI abnormalities The degree is closely related to the result of aEEG abnormality. Conclusions aEEG is a sensitive indicator of early diagnosis and prognosis in children with HIE. The lower the Apgar score, the lower the blood pH, the higher the risk of aEEG. The MRI and aEEG are both sensitive indicators of HIE diagnosis. aEEG is significantly superior to cranial MRI in terms of timeliness and convenience.