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[高原地区住院新生儿振幅整合脑电图监测结果]

[Amplitude-integrated electroencephalography monitoring results of hospitalized neonates in plateau areas].

作者信息

Zhao Xiao-Fen, Cheng Guo-Qiang, Zhao Peng-Na, Zhao Mei, Zhu Shuang-Yan, Li Yang-Fang, Zhou Wen-Hao

机构信息

Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 Aug 15;26(8):817-822. doi: 10.7499/j.issn.1008-8830.2402078.

Abstract

OBJECTIVES

To investigate the amplitude-integrated electroencephalography (aEEG) monitoring results of hospitalized neonates in plateau areas.

METHODS

A retrospective analysis was conducted on 5 945 neonates who were admitted to the Department of Neonatology, Kunming Children's Hospital, and received aEEG monitoring from January 2020 to December 2022. According to the aEEG monitoring results, they were divided into a normal aEEG group and an abnormal aEEG group. The incidence rate of aEEG abnormalities was analyzed in neonates with various systemic diseases, as well as the manifestations of aEEG abnormalities and the consistency between aEEG abnormalities and clinical abnormalities.

RESULTS

Among the 5 945 neonates, the aEEG abnormality rate was 19.28% (1 146/5 945), with an abnormality rate of 29.58% (906/3 063) in critically ill neonates and 8.33% (240/2 882) in non-critically ill neonates (<0.05). The children with inherited metabolic diseases showed the highest aEEG abnormality rate of 60.77% (79/130), followed by those with central nervous system disorders [42.22% (76/180)] and preterm infants [35.53% (108/304)]. Compared with the normal aEEG group, the abnormal aEEG group had significantly lower age and gestational age, as well as a significantly lower birth weight of preterm infants (<0.05). Among the 1 146 neonates with aEEG abnormalities, the main types of aEEG abnormalities were sleep cycle disorders in 597 neonates (52.09%), background activity abnormalities in 294 neonates (25.65%), and epileptiform activity in 255 neonates (22.25%), and there were 902 neonates (78.71%) with abnormal clinical manifestations. The sensitivity and specificity of aEEG monitoring for brain function abnormalities were 33.51% and 92.50%, respectively.

CONCLUSIONS

In plateau areas, there is a relatively high rate of aEEG abnormalities among hospitalized neonates, particularly in critically ill neonates and those with smaller gestational ages and younger ages, suggesting a high risk of brain injury. Therefore, routine aEEG monitoring for the hospitalized neonates can help with the early detection of brain function abnormalities, the decision-making in treatment, and the formulation of brain protection strategies.

摘要

目的

探讨高原地区住院新生儿振幅整合脑电图(aEEG)监测结果。

方法

回顾性分析2020年1月至2022年12月在昆明市儿童医院新生儿科住院并接受aEEG监测的5945例新生儿。根据aEEG监测结果,将其分为aEEG正常组和aEEG异常组。分析不同系统疾病新生儿aEEG异常的发生率、aEEG异常表现以及aEEG异常与临床异常的一致性。

结果

5945例新生儿中,aEEG异常率为19.28%(1146/5945),其中危重症新生儿异常率为29.58%(906/3063),非危重症新生儿异常率为8.33%(240/2882)(P<0.05)。遗传代谢性疾病患儿aEEG异常率最高,为60.77%(79/130),其次为中枢神经系统疾病患儿[42.22%(76/180)]和早产儿[35.53%(108/304)]。与aEEG正常组相比,aEEG异常组患儿年龄、胎龄显著更低,早产儿出生体重也显著更低(P<0.05)。1146例aEEG异常新生儿中,aEEG异常主要类型为睡眠周期紊乱597例(52.09%)、背景活动异常294例(25.65%)、癫痫样活动255例(22.25%),有902例(78.71%)有临床异常表现。aEEG监测脑功能异常的敏感度和特异度分别为33.51%和92.50%。

结论

在高原地区,住院新生儿aEEG异常率较高,尤其是危重症新生儿以及胎龄小、年龄小的新生儿,提示脑损伤风险高。因此,对住院新生儿常规进行aEEG监测有助于早期发现脑功能异常、辅助治疗决策及制定脑保护策略。

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