Hughes J R, Guerra R
Department of Neurology, University of Illinois Medical Center at Chicago 60612.
Clin Electroencephalogr. 1994 Oct;25(4):127-35. doi: 10.1177/155005949402500404.
The goal of this study was to investigate the factors that could predict prognosis in 51 premature infants with positive sharp waves on their EEGs (gestational age 23-36 wks) with 114 tracings. Follow-up clinical examinations were conducted, up to 10 yrs later. Death occurred in 18%, from a non-CNS cause, either sepsis or a congenital cardiac or pulmonary defect. A severe outcome was seen in 8% and was related to maternal i.v. drug abuse (IVDA) and the presence of many positive sharp waves. A moderate outcome, noted in 29%, was associated with a Grade III-IV intracerebral hemorrhage (ICH) or periventricular leukomalacia (PVL) and maternal IVDA. A mild outcome seen in 20% was related to infrequent positive sharp waves, vaginal delivery and an improving EEG over time, while a normal outcome (26%) was also related to infrequent discharges, a normalized EEG over time, a normal sonogram and the absence of clinical seizures. The addition of negative sharp waves to the positive ones and the addition of central to temporal positive sharp waves were associated less often with a normal outcome. The general conclusion of this study was that various aspects of positive sharp waves in premature infants, in addition to other factors, can be used to predict outcome in these neonates.
本研究的目的是调查51例脑电图出现正锐波的早产儿（胎龄23 - 36周）共114份脑电图记录中能够预测预后的因素。进行了随访临床检查，随访时间长达10年。18%的患儿死于非中枢神经系统原因，即败血症、先天性心脏或肺部缺陷。8%的患儿出现严重预后，与母亲静脉药物滥用（IVDA）及众多正锐波的存在有关。29%的患儿预后中等，与III - IV级脑室内出血（ICH）或脑室周围白质软化（PVL）以及母亲IVDA有关。20%的患儿预后轻微，与正锐波出现频率低、阴道分娩及脑电图随时间改善有关，而26%的患儿预后正常也与放电频率低、脑电图随时间恢复正常、超声检查正常及无临床惊厥有关。正锐波中加入负锐波以及中央区正锐波与颞区正锐波同时出现时，预后正常的情况较少。本研究的总体结论是，除其他因素外，早产儿正锐波的各个方面可用于预测这些新生儿的预后。
