振幅整合脑电图随访指标与极低出生体重儿神经预后相关性分析

doi:10.12372/jcp.2022.21e1476

Abstract

Abstract:

Objective To analyze the correlation between amplitude-integrated electroencephalogram (aEEG) follow-up indicators and the neurological prognosis in very low birth weight infants. Methods A total of 224 very low birth weight infants delivered from January 2016 to January 2019 were selected for aEEG monitoring within one week after birth and at 3, 6 and 12 months of corrected gestational age. According to the neurological development outcome at 12 months of corrected gestational age, the infants were divided into normal group and abnormal group, and the difference of aEEG monitoring score between the two groups was compared. Results A total of 224 very low birth weight infants (125 boys and 99 girls) were included, the gestational age was (30.01±1.49) weeks and the birth weight was (1366.64±119.43) g. At 12 months of corrected gestational age, the nervous system development outcome was normal in 153 cases and abnormal in 71 cases. Within one week of birth, there was a statistically significant difference in sleep cycle (Cy) and total (T) scores between normal and abnormal groups (P<0.05). There were significant differences in graph continuity (Co), Cy and T scores between the two groups at 3 and 6 months of corrected gestational age (P<0.05). At 12 months of corrected gestational age, there were significant differences in Co, lower bound amplitude (LB), Cy, bandwidth (B) and T scores between the two groups (P<0.05). Binary logistic regression analysis showed that Co, Cy and T scores in aEEG monitoring indexes at 12 months of corrected gestational age were significantly correlated with the nervous system development outcome of very low birth weight infants (P<0.01), and the lower the score, the greater the risk of abnormal neurodevelopmental outcome. By drawing ROC curve, Co and T scores of aEEG at 12 months of gestational age were found to have moderate predictive value for the neurological outcome of very low birth weight infants (AUC 0.71 and 0.82). Conclusions The aEEG follow-up indicators are correlated with the neurological prognosis in very low birth weight infants and have certain predictive value.

Key words: amplitude integrated electroencephalogram, follow-up indicator, very low birth weight infant

ZENG Xiaoliang, MIN Qing, WU Shuyuan. Correlation analysis of amplitude-integrated electroencephalogram follow-up indicators and neurological prognosis of very low birth weight infants[J].Journal of Clinical Pediatrics, 2022, 40(9): 679-684.

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References 25

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分值	Co	LB	Cy	B
0	不连续	<3 μV	无	低振幅（≤15 μV）和低电压（≤5 μV）
1	有些连续	3~5 μV	开始出现周期	高振幅（>20 μV）或中等振幅（16~20 μV）和低电压（≤5 μV）
2	连续	>5 μV	似乎有周期变化	高振幅（>20 μV）和高电压（>5 μV）
3			有周期变化,但存在打断情况	中等振幅（16~20 μV）和高电压（>5 μV）
4			有明确的周期且没有打断情况	低振幅（≤15 μV）和高电压（>5 μV）
5			规律且成熟

项目	异常组(n=71)	正常组(n=153)	统计量	P
胎龄(x±s)/周	30.24±1.37	29.91±1.54	t=1.54	0.124
体重(x±s)/g	1 371.65±116.28	1 364.32±120.89	t=0.43	0.670
男性[n(%)]	37(52.1)	88(57.5)	χ²=0.57	0.449
剖宫产[n(%)]	29(40.9)	49(32.0)	χ²=1.66	0.197
胎膜早破[n(%)]	21(29.6)	54(35.3)	χ²=0.71	0.399
妊娠期糖尿病[n(%)]	44(62.0)	102(66.7)	χ²=0.47	0.493
机械通气[n(%)]	48(67.6)	96(62.8)	χ²=0.50	0.480

组别	Co评分	LB评分	Cy评分	B评分	T评分
出生1周内
异常组(n=71)	0.95±0.26	1.01±0.24	1.27±0.35	1.39±0.42	4.62±1.07
正常组(n=153)	0.97±0.30	1.02±0.20	1.46±0.39	1.45±0.27	4.94±1.12
t值	0.484	0.326	2.949	1.286	2.018
P	0.629	0.745	0.004	0.200	0.045
矫正胎龄3月龄
异常组(n=71)	0.97±0.26	1.02±0.26	1.31±0.47	1.43±0.46	4.75±1.18
正常组(n=153)	1.06±0.34	1.04±0.23	1.58±0.56	1.52±0.38	5.20±1.24
t值	1.98	0.58	3.53	1.54	2.57
P	0.049	0.562	0.001	0.125	0.011
矫正胎龄6月龄
异常组(n=71)	1.05±0.38	1.13±0.34	1.87±0.62	1.72±0.31	5.77±1.94
正常组(n=153)	1.19±0.44	1.21±0.30	2.39±0.85	1.79±0.44	6.71±2.13
t值	2.31	1.78	4.61	1.21	3.16
P	0.022	0.077	<0.001	0.228	0.002
矫正胎龄12月龄
异常组(n=71)	1.22±0.42	1.24±0.32	2.04±0.64	2.13±0.56	6.68±2.46
正常组(n=153)	1.42±0.54	1.42±0.49	3.12±1.18	2.59±0.88	8.35±2.91
t值	2.76	2.83	7.23	4.04	4.19
P	0.006	0.005	<0.001	<0.001	<0.001

aEEG监测得分	回归系数	标准误	χ²值	P	OR(95%CI)
Co评分	–0.14	0.51	0.08	<0.001	0.87(0.71~0.94)
LB评分	–0.58	0.73	0.63	0.343	0.56(0.31~1.48)
Cy评分	–0.20	0.48	0.17	<0.001	0.82(0.68~0.89)
B评分	–0.45	0.68	0.43	0.267	0.64(0.28~1.24)
T评分	–0.07	0.39	0.04	<0.001	0.93(0.81~0.97)
常量	–6.91	1.25	30.69	<0.001	0.001

评分	截断值/分	AUC	95%CI	灵敏度/%	特异度/%	阳性预测值/%	阴性预测值/%
Co	1	0.71	0.56~0.84	79.26	72.18	74.83	69.72
Cy	3	0.68	0.55~0.83	76.47	70.51	71.96	67.48
T	7	0.82	0.74~0.93	84.26	79.74	86.26	85.18

Correlation analysis of amplitude-integrated electroencephalogram follow-up indicators and neurological prognosis of very low birth weight infants

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