振幅整合脑电图联合P50 对重症脑血管病 患者预后结局的评估

Value of aEEG combined with P50 in evaluating the prognosis of patients with severe cerebrovascular disease

摘要:

目的 研究振幅整合脑电图联合感觉门控电位P50 对重症脑血管病患者预后结局的评估价值。 方法 选取2017 年5 月—2019 年5 月郴州市第一人民医院诊治的重症脑血管病患者62 例。根据患者预后情 况将其分成病死组（14 例）和预后良好组（48 例），比较两组患者振幅整合脑电图、P50 结果；分析振幅整 合脑电图、P50 与格拉斯哥预后评分表（GOS）评分的相关性；评估振幅整合脑电图、P50 单独与联合检测 对患者的预后价值。结果 两组振幅整合脑电图分级比较，差异有统计学意义（P <0.05）。病死组P50 较预 后良好组高（P <0.05）。预后良好组GOS 评分较病死组高（P <0.05）。振幅整合脑电图、P50 与GOS 评分呈 负相关（r s =-0.629 和-0.703，均P <0.05）。联合检测对患者预后的价值高于振幅整合脑电图、P50单独检测 （P <0.05）。结论 P50 联合振幅整合脑电图检测对重症脑血管病患者具有较高的预后评估价值。

Abstract:

Objective To investigate value of amplitude integrated electroencephalogram (aEEG) combined with sensory gating potential (P50) in evaluating the prognosis of patients with severe cerebrovascular disease. Methods Sixty-two cases of severe cerebrovascular disease in our hospital from May 2017 to May 2019 were enrolled, and were divided into poor prognosis group (n = 14) and good prognosis group (n = 48) according to their prognosis. The results of aEEG and P50 were compared between the two groups, and GOS score was further assessed. The correlation between aEEG as well as P50 and GOS score was analyzed. Then the prognostic value of single aEEG or P50 and the combined tests were determined. Results Rank-sum test showed that the aEEG grading was significantly different between groups (χ2=15.240, P = 0.000). The t-test showed that there was a significant difference in P50 between groups (t =10.633, P = 0.000), and P50 of poor prognosis group was higher than that of good prognosis group. Besides, t-test showed that GOS score was significantly different between groups (t =17.253, P = 0.000), where GOS score of good prognosis group was higher than that of poor prognosis group. Additionally, GOS score was negatively correlated with P50 (r s =-0.703) and aEEG (r s =-0.629). The AUC, sensitivity, and specificity of aEEG combined with P50 were 0.967, 100.00%, and 91.7%, while those of P50 were 0.807, 78.60% and 93.7% and those of aEEG were 0.732, 35.70% and 97.90%. The predictive value of combined detection of P50 and aEEG was better than that of single detection of P50 or aEEG (P < 0.05). Conclusions P50 combined with aEEG is of high prognostic value in patients with severe cerebrovascular diseases, though the results need to be further analyzed and confirmed by expanding the sample size.