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目的通过分组对比分析,研究振幅整合脑电图(a EEG)评估早产儿脑损伤(BIPI)的价值。方法以2015年6月-2016年6月在该院出生并转入新生儿科的182例早产儿为研究对象,早产儿生后6 h内进行a EEG评分,依据BIPI诊断结果,分为脑损伤组(99例)和非脑损伤组(83例),对导致BIPI的危险因素进行回归性分析,依照a EEG检测结果不同再分为a EEG正常组(92例)和a EEG异常组(90例),对影响早产儿a EEG结果的因素进行单因素分析。结果脑损伤组中a EEG异常83例(83.8%);非脑损伤组中a EEG异常9例(10.8%),两组a EEG异常率比较差异有统计学意义(P<0.05)。Logistic回归分析显示:小胎龄(<32周)、低出生体重(<1500g)、胎盘胎膜与脐带异常及妊娠期高血压疾病是导致BIPI发生的高危因素(P<0.05)。a EEG正常组与a EEG异常组在出生体重、胎龄、胎盘胎膜与脐带异常及妊娠期高血压疾病四方面比较,差异有统计学意义(P<0.05)。结论 BIPI危险因素及早产儿早期a EEG影响因素一致,提示早期a EEG能有效评价早产儿的脑功能状态,有助于早期诊断BIPI。
Objective To investigate the value of amplitude integrated electroencephalogram (a EEG) in assessing brain injury in preterm infants (BIPI) by grouping comparative analysis. Methods A total of 182 preterm infants born in the hospital from June 2015 to June 2016 were enrolled in the neonatology department. The EEG scores of preterm infants within 6 hours after birth were divided into three groups according to the diagnostic results of BIPI: brain injury Group A (99 cases) and non-brain injury group (83 cases). The risk factors leading to BIPI were analyzed retrospectively. According to the results of a EEG test, the patients were divided into two groups: a normal EEG group (n = 92) Cases), univariate analysis of the factors that affect the results of a EEG in preterm infants. Results There were 83 cases (83.8%) with abnormal EEG in brain injury group and 9 cases (10.8%) with abnormal EEG in non-brain injury group. There was significant difference in abnormal rate of a EEG in both groups (P <0.05). Logistic regression analysis showed that low gestational age (<32 weeks), low birth weight (<1500g), abnormalities of placenta and umbilical cord and hypertensive disorder complicating pregnancy were the risk factors for BIPI (P <0.05). There was statistically significant difference between the normal EEG group and the abnormal EEG group in terms of birth weight, gestational age, abnormality of fetal membranes and umbilical cord abnormalities and hypertensive disorder of pregnancy (P <0.05). Conclusions BIPI risk factors and early EEG a EEG influencing factors, suggesting that early a EEG can effectively evaluate brain function in preterm children, contribute to the early diagnosis of BIPI.