定量脑电图对重症监护室脑梗死患者的长期预后的指导价值研究

发布时间：2018-07-27 10:53

【摘要】：研究目的:脑卒中是成人致死致残的主要原因之一。本文研究目的在于探讨定量脑电图对重症脑梗死患者预后的预测价值,并探索最佳预测指标。研究方法:对收入神经内科重症监护室的22名首次发病的幕上脑梗死患者,在发病24-72h进行脑电图监测。同时对其进行美国国立卫生院卒中量表(The National Institutes of Health Stroke Scale,NIHSS)评分以及头部梗死范围评估。发病6个月后进行电话随访,用m RS(modified Rankin Scale)评估患者预后。选择具有代表性原始EEG片段进行定量分析。将定量脑电图频谱指标与患者6个月预后进行相关性分析。根据预后比较患者定量脑电图频谱指标,并进行受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析。研究结果:1、相对δ功率、(δ波功率+θ波功率)/(α波功率+β波功率)、(δ波功率/α波功率)、NIHSS评分、梗死面积与患者6月的m RS呈正相关。相对θ功率、相对α功率与患者6月的m RS呈负相关。2、死亡组患者与存活组患者在梗死面积、NIHSS评分、相对δ功率、相对α功率、相对θ功率、DAR以及DTABR等方面均有统计学差异。在QEEG指标中,相对δ功率能有效区分死亡组和非死亡组,准确率高达86.36%。3、中度残疾与重度残疾在年龄、相对δ功率、相对θ功率以及(δ波功率/α波功率)等方面存在统计学差异。其中相对θ功率能有效分辨中度残疾和重度残疾组,准确率92.86%。研究结论:定量脑电图对重症监护室脑梗死患者6月的预后具有明显的提示作用。
[Abstract]:Objective: stroke is one of the main causes of death and disability in adults. The purpose of this study was to explore the prognostic value of quantitative electroencephalogram (QEEG) in patients with severe cerebral infarction and to explore the best predictor. Methods: electroencephalogram (EEG) monitoring was performed in 22 patients with supratentorial cerebral infarction who were admitted to the neurology intensive care unit for 24-72 hours. The National Institutes of Health (NIH) Stroke scale (The National Institutes of Health Stroke scale NIHSS) and head infarct size were also evaluated. Patients were followed up by telephone 6 months after onset and m RS (modified Rankin Scale) was used to evaluate the prognosis. The representative original EEG fragments were selected for quantitative analysis. The correlation between quantitative electroencephalogram (QEEG) spectrum index and 6 months prognosis was analyzed. The quantitative electroencephalogram (EEG) spectral indices were compared according to the prognosis, and the operating characteristic curve (receiver operating characteristic curveROC curve) was analyzed. The results showed that there was a positive correlation between infarct size and MRs of patients in 6 months. The results were as follows: 1: 1, relative 未 power, (未 wave power 胃 wave power) / (伪 wave power, 尾 wave power,), (未 wave power / 伪 wave power) had a positive correlation with the infarct size. Relative 胃 power and relative 伪 power were negatively correlated with Mrs in 6 months. There were significant differences in infarct area, relative 未 power, relative 伪 power, relative 胃 power and DTABR between patients with death and those with survival. In QEEG, relative 未 power can effectively distinguish the death group from the non-dead group, and the accuracy is as high as 86.36. 3. There are statistical differences in age, relative 未 power, relative 胃 power and (未 wave power / 伪 wave power) between moderate disability and severe disability. The relative 胃 power can effectively distinguish moderate and severe disability groups, and the accuracy rate is 92.86. Conclusion: quantitative electroencephalogram (QEEG) has a significant effect on the prognosis of patients with cerebral infarction in intensive care unit (ICU) for 6 months.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.33

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