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振幅整合脑电图联合头颅磁共振成像对早产儿脑白质发育异常的预测价值▲
The predictive value of amplitude-integrated electroencephalography combined with cranial magnetic resonance imaging for white matter dysplasia in preterm infants

内科 202419卷05期 页码:477-481

作者机构: 广西河池市第一人民医院1新生儿科,2麻醉科,3重症医学科,4儿童康复科,5医学影像科,河池市 547000

基金信息:▲基金项目:广西壮族自治区卫生健康委员会自筹经费科研课题(Z20211054) 通信作者:蓝国海

DOI:10.16121/j.cnki.cn45⁃1347/r.2024.05.03

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目的 探讨振幅整合脑电图(aEEG)联合头颅磁共振成像(cMRI)对早产儿脑白质发育异常的预测价值。方法 选取100例早产儿作为研究对象[出生后6 h内行aEEG检查,出生后3 d内行cMRI检查,校正胎龄42周时行新生儿行为神经测定(NBNA)评估],并据NBNA评分将早产儿分为正常组、异常组。比较两组的aEEG评分和cMRI指标[两半球间距(IHD)、双顶径(BPW)],并应用受试者操作特征(ROC)曲线评估aEEG评分联合cMRI指标对早产儿脑白质发育异常的预测价值。结果 100例早产儿中,正常组(NBNA评分≥37分)45例,异常组(NBNA评分<37分)55例,两组基线资料差异均无统计学意义(均P>0.05)。异常组aEEG评分低于正常组,IHD大于正常组,BPW小于正常组(均P<0.05)。ROC曲线分析显示,aEEG评分联合cMRI指标IHD、BPW预测早产儿脑白质发育异常的敏感性、特异性分别为90.31%、80.72%。结论 aEEG、cMRI能反映早产儿脑白质发育情况,二者联合预测早产儿脑白质发育异常的效能良好。

【Abstract】 Objective To investigate the predictive value of amplitude-integrated electroencephalography (aEEG) combined with cranial magnetic resonance imaging (cMRI) for white matter dysplasia in preterm infants. Methods A total of 100 preterm infants were selected as the study subjects, all of whom received aEEG within 6 hours after birth, cMRI within 3 days after birth, and Neonatal Behavioral Neurological Assessment (NBNA) at 42 weeks of corrected gestational age. According to the NBNA score, preterm infants were divided into the normal group or the abnormal group. The aEEG score and cMRI indexes [interhemispheric distance (IHD) and biparietal diameter (BPW)] were compared between the two groups, and receiver operating characteristic (ROC) curves were used to evaluate the predictive value of aEEG score combined with cMRI indexes for white matter dysplasia in preterm infants. Results Of the 100 preterm infants, 45 cases were in the normal group (NBNA score ≥ 37 points), 55 cases were in the abnormal group (NBNA score < 37 points), and there was no statistically significant difference in the baseline data between the two groups (all P>0.05). Compared with the normal group, the abnormal group had a lower aEEG score, a greater IHD, and a shorter BPW (all P<0.05). The ROC curve analysis showed that the sensitivity and specificity of the combination of aEEG score and cMRI indexes (IHD and BPW) were 90.31% and 80.72%, respectively, in predicting white matter dysplasia in preterm infants. Conclusion aEEG and cMRI can reflect the development of white matter in preterm infants, and their combination shows great efficacy in predicting white matter dysplasia in preterm infants.

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