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脑干出血患者的监测:定量脑电图与经颅多普勒的同步研究。

Monitoring of patients with brainstem hemorrhage: A simultaneous study of quantitative electroencephalography and transcranial Doppler.

机构信息

Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin 130021, China.

出版信息

Clin Neurophysiol. 2021 Apr;132(4):946-952. doi: 10.1016/j.clinph.2020.12.026. Epub 2021 Feb 5.

DOI:10.1016/j.clinph.2020.12.026
PMID:33636610
Abstract

OBJECTIVE

To explore whether quantitative electroencephalography (QEEG) and transcranial Doppler (TCD) can be used to evaluate patients with acute severe brainstem hemorrhage (ASBH).

METHODS

We prospectively enrolled patients with ASBH and assessed their mortality at the 90-day follow-up. The patients' demographic data, serological data, and clinical factors were recorded. Quantitative brain function monitoring was performed using a TCD-QEEG recording system attached to the patient's bedside.

RESULTS

Thirty-one patients (55.3 ± 10.6 years; 17 men) were studied. Mortality at 90 days was at 61.3%. There was no significant difference in TCD-related parameters between the survival group and the death group (p > 0.05). Among the QEEG-related indexes, only the (delta + theta)/(alpha + beta) ratio (DTABR) (odds ratio 11.555, 95%confidence interval 1.413-94.503, p = 0.022) was an independent predictor of clinical outcome; the area under the ROC curve of DTABR was 0.921, cut-off point was 3.88, sensitivity was 79%, and specificity was 100%.

CONCLUSIONS

In patients with ASBH, QEEG can effectively inform the clinical prognosis regarding 90-day mortality, while TCD cannot.

SIGNIFICANCE

QEEG shows promise for informing the mortality prognosis of patients with ASBH.

摘要

目的

探索定量脑电图(QEEG)和经颅多普勒(TCD)是否可用于评估急性严重脑干出血(ASBH)患者。

方法

前瞻性纳入 ASBH 患者,并在 90 天随访时评估其死亡率。记录患者的人口统计学数据、血清学数据和临床因素。使用连接到患者床边的 TCD-QEEG 记录系统进行定量脑功能监测。

结果

共纳入 31 例患者(55.3±10.6 岁;17 名男性)。90 天死亡率为 61.3%。存活组和死亡组之间 TCD 相关参数无显著差异(p>0.05)。在 QEEG 相关指标中,仅(delta+theta)/(alpha+beta)比值(DTABR)(优势比 11.555,95%置信区间 1.413-94.503,p=0.022)是临床结局的独立预测因素;DTABR 的 ROC 曲线下面积为 0.921,截断点为 3.88,灵敏度为 79%,特异性为 100%。

结论

在 ASBH 患者中,QEEG 可有效反映 90 天死亡率的临床预后,而 TCD 则不能。

意义

QEEG 有望为 ASBH 患者的死亡率预后提供信息。

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