振幅整合脑电图联合头颅磁共振预测早产儿矫正12月龄时神经发育的价值

doi:10.3969/j.issn.1000-8535.2024.05.009

广州医药 ›› 2024, Vol. 55 ›› Issue (5): 513-518.DOI: 10.3969/j.issn.1000-8535.2024.05.009

振幅整合脑电图联合头颅磁共振预测早产儿矫正12月龄时神经发育的价值

黄丹¹, 蓝国海², 刘祥晖¹, 覃荣苗³, 梁秋艳⁴, 夏文强⁵

1 河池市第一人民医院新生儿科（广西河池 547000）
2 河池市第一人民医院麻醉科（广西河池 547000）
3 河池市第一人民医院重症医学科（广西河池 547000）
4 河池市第一人民医院儿童康复科（广西河池 547000）
5 河池市第一人民医院医学影像科（广西河池 547000）

收稿日期:2023-12-10 出版日期:2024-05-20 发布日期:2024-06-28
通讯作者: 蓝国海,E-mail：garen156@163.com
基金资助:
广西壮族自治区卫生健康委员会自筹经费科研课题（Z20211054）

Predictive value of aEEG combined with cranial MRI on neurodevelopment for preterm infants at corrected age of 12 months

HUANG Dan¹, LAN Guohai², LIU Xianghui¹, QIN Rongmiao³, LIANG Qiuyan⁴, XIA Wenqiang⁵

1 Department of Neonatology,The First People’s Hospital of Hechi City,Hechi 547000,China
2 Department of Anesthesiology,The First People’s Hospital of Hechi City,Hechi 547000,China
3 Department of Critical Care Medicine,The First People’s Hospital of Hechi City,Hechi 547000,China
4 Department of Child Rehabilitation,The First People’s Hospital of Hechi City,Hechi 547000,China
5 Department of Medical Imaging,The First People’s Hospital of Hechi City,Hechi 547000,China

Received:2023-12-10 Online:2024-05-20 Published:2024-06-28

摘要/Abstract

摘要： 目的探讨振幅整合脑电图（aEEG）联合头颅磁共振成像（cMRI）对早产儿矫正12月龄时神经发育的预测价值。方法选取110例早产儿为研究对象,并在矫正12月龄时采用Gesell 发育量表评估发育商（DQ）,依据DQ分为Gesell 正常组（DQ≥85,n=83）、Gesell 异常组（DQ<85,n=27）。采集早产儿及母亲临床资料,对比两组出生后72 h内aEEG、矫正胎龄37周时cMRI检查指标差异。结果两组早产儿及母亲基线资料比较差异无统计学意义（P>0.05）。相较于Gesell 正常组,Gesell 异常组双顶径（BPW）降低[（70.68±5.32）mm vs（66.54±3.69）mm],睡眠-觉醒周期（SWC）不成熟率（20.48% vs 85.19%）、aEEG异常率（30.12% vs 70.37%）、两半球间距（IHD）增高[（2.95±0.83） mm vs（3.56±0.72）mm]（P<0.05）。Pearson相关分析结果显示,DQ值与IHD呈负相关,DQ值与BPW呈正相关（r=-0.361、0.598,P<0.05）。二元Logistic回归分析结果显示,BPW增高是Gesell 异常的独立保护因素（P<0.05）,IHD增高、SWC不成熟及aEEG异常是Gesell 异常的独立危险因素（P<0.05）。结论早产儿出生后72 h内aEEG异常、矫正胎龄37周时cMRI异常可能提示矫正12月龄时不良神经发育结局。

关键词: 早产儿, 神经发育, 振幅整合脑电图, 头颅磁共振成像

Abstract: Objective To evaluate the predictive value of amplitude-integrated electroencephalogram combined with cranial magnetic resonance on neurodevelopment for preterm infants at corrected age of 12 months．Methods A total of 110 preterm infants were selected as study subjects,and Gesell developmental scale was used to evaluate developmental quotient（DQ）at corrected age of 12 months．According to DQ,they were divided into normal Gesell group（DQ≥85,n=83）and abnormal Gesell group（DQ<85,n=27）．Clinical data of preterm infants and their mothers were collected,and the differences of amplitude-integrated electroencephalogram and cranial MRI（cMRI）were compared between two groups．Results There was no significant difference in baseline data between two groups（P>0.05）．Compared with the normal Gesell group,the biparirtal width（BPW）in the abnormal Gesell group was decreased（70.68±5.32mm vs 66.54±3.69mm）,the immaturity rate of sleep-wake cycle（SWC）（20.48% vs 85.19%）,the abnormal rate of aEEG（30.12% vs 70.37%）,and（IHD）（2.95±0.83mm vs 3.56±0.72mm）were increased（P<0.05）．The results of Pearson correlation analysis showed that DQ was negatively correlated with IHD,and DQ was positively correlated with BPW（r=-0.361、0.598,P<0.05）．Binary Logistic regression analysis showed that increased BPW was an independent protective factor for abnormal Gesell（P<0.05）,and increased IHD,immature SWC and abnormal aEEG were independent risk factors for abnormal Gesell（P<0.05）．Conclusions Abnormal aEEG within 72h after birth and abnormal cMRI at corrected age of 37 weeks may lead to adverse neurodevelopmental outcomes at corrected age of 12 months．

Key words: preterm infant, neurodevelopment, amplitude-integrated electroencephalogram, cranial magnetic resonance imaging

黄丹, 蓝国海, 刘祥晖, 覃荣苗, 梁秋艳, 夏文强. 振幅整合脑电图联合头颅磁共振预测早产儿矫正12月龄时神经发育的价值[J]. 广州医药, 2024, 55(5): 513-518.

HUANG Dan, LAN Guohai, LIU Xianghui, QIN Rongmiao, LIANG Qiuyan, XIA Wenqiang. Predictive value of aEEG combined with cranial MRI on neurodevelopment for preterm infants at corrected age of 12 months[J]. Guangzhou Medical Journal, 2024, 55(5): 513-518.

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振幅整合脑电图联合头颅磁共振预测早产儿矫正12月龄时神经发育的价值

Predictive value of aEEG combined with cranial MRI on neurodevelopment for preterm infants at corrected age of 12 months

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