振幅整合脑电图在不同胎龄早产儿监测的背景活动特点及对脑功能预后评估的价值

Characteristics of Background Activity in Amplitude-Integrated Electroencephalography Monitoring of Premature Infants of Different Gestational Ages and Its Value in Evaluating Brain Functional Prognosis

摘要: 目的：探究振幅整合脑电图(aEEG)在不同胎龄早产儿背景活动监测和脑功能预后评估临床中的应用价值。方法：本试验通过选择2022年8月至2024年1月在医院收治的早产儿60例作为本次试验研究对象，采用振幅整合脑电图联合磁共振成像进行检查，研究aEEG各项指标随胎龄、日龄增长的变化规律，根据日龄的增长情况，划分为：日龄3日、日龄1周、日龄2周、纠正胎龄40周，同时结合早产儿纠正胎龄40周的头颅磁共振成像(MRI)结果，评估早期aEEG各指标对早产儿脑损伤的预测价值；同时随访生后1周岁时的婴幼儿智能发育量表(CDCC)和贝利婴幼儿发育量表(BSID)评估结果，比较早期aEEG结果与1周岁时MDI、PDI的相关性。结果：早产儿在日龄3日、日龄1周、日龄2周、纠正胎龄40周时的aEEG的结果差异明显，且随着日龄增加，aEEG检测结果显示早产儿脑电异常率越来越低，且接近早产儿纠正胎龄40周的检测结果(P < 0.05)；早期aEEG结果中正常、轻度、重度患者1周岁时的MDI、PDI、CDCC评分结果随着严重程度逐渐降低，且存在差异性(P < 0.05)，评分与aEEG成反比。结论：振幅整合脑电图联合磁共振成像能够对不同胎龄早产儿的脑功能情况进行监测，了解不同胎龄早产儿病情情况，判断严重程度，且对预后脑功能发育情况进行评估的价值较高。

Abstract: Objective: To explore the clinical value of amplitude integrated electroencephalography (aEEG) in monitoring background activity and evaluation of brain function prognosis in preterm infants with different gestational ages. Methods: In this trial, 60 cases of premature infants admitted to the hospital from August 2022 to January 2024 were selected as the subjects of this study. The study used amplitude-integrated electroencephalography combined with magnetic resonance imaging to examine the changes in various aEEG indicators with gestational age and postnatal age, dividing them into: 3 days postnatal, 1 week postnatal, 2 weeks postnatal, and corrected gestational age of 40 weeks. At the same time, it combined the results of cranial magnetic resonance imaging (MRI) for preterm infants at corrected gestational age of 40 weeks, to evaluate the predictive value of early aEEG indicators for brain injury in preterm infants; At the same time, the results of infant intelligence development scale (CDCC) and Bailey Infant Development Scale (BSID) were evaluated at 1 year of age to compare the correlation between early aEEG results and MDI and PDI at 1 year of age. Results: The results of aEEG in preterm infants at 3 days, 1 week, 2 weeks and corrected gestational age of 40 weeks showed significant differences, and with the increase of age, the detection results of aEEG showed that the rate of abnormal brain electricity in preterm infants was decreasing, and close to the detection results of preterm infants at corrected gestational age of 40 weeks (P < 0.05); In the early aEEG results, the MDI, PDI and CDCC scores of normal, mild and severe patients decreased gradually with the severity at 1 year old, and there were differences (P < 0.05). The scores were inversely proportional to the aEEG. Conclusion: Amplitude integrated EEG combined with magnetic resonance imaging can monitor the brain function of premature infants at different gestational ages, understand the condition of preterm infants at different gestational ages, judge the severity, and evaluate the development of prognosis brain function.