关键词: 缺氧缺血性脑病, 振幅整合脑电图, 定量分析, 发育商, 新生儿

Abstract: Objective To investigate the regularity characteristics of brain function of neonates with hypoxic ischaemic encephalopathy(HIE),and to discuss the value of the quantitative indexes in predicting prognosis of HIE. Methods Totally 60 HIE neonates admitted in the neonatal intensive care unit of the Affiliated Hospital of Yan′an University within 6 hours after birth were enrolled in this study,and were divided into mild group,moderate group and severe group according to the diagnostic criteria of HIE.And 20 non-HIE children were selected as control group at the same time.Amplitude integrated electroencephalogram(aEEG) monitoring was performed within six hours after admitted to the hospital,and the duration lasted for 12 hours.The quantitative measures of amplitude,discontinuity,relative delta power(RDP) among four groups were analyzed.The neonates were followed up for three months.The developmental quotient(DQ) was assessed when the infants was three months old.And the correlation between DQ and the quantitative indexes such as amplitude,discontinuity,RDP was analyzed. Results There were significant differences on highest/lowest amplitude,discontinuity,RDP among the four groups(P＜0.05).The control group was not significantly different from mild HIE groupon amplitude,discontinuity and RDP(P＞0.016 7).However,there were significant differences on highest/lowest amplitude,discontinuity and RDP between mild and moderate HIE group,moderate and severe HIE group(P＜0.016 7).The amplitude and RDP decreased from mild HIE group to severe HIE group,while the discontinuity of aEEG signal increased from mild HIE group to severe HIE group.DQ of the children decreased with the increase of HIE severity(P＜0.05).The DQ value was positively correlated with the lowest amplitude(r=0.756,P＜0.05) and RDP(r=0.526,P＜0.05),negatively related to the discontinuity(r=-0.684,P＜0.05).But the correlation between DQ and the highest amplitude was not significant (P＞0.05). Conclusions With the aggravation of HIE,the discontinuity,amplitude and RDP become lower.There is correlative relationship between HIE and DQ at the age of three months old.Moreover,DQ value is positively correlated with the lowest amplitude and RDP,and is negatively related to the discontinuity.The lowest amplitude,discontinuity and RDP are partly associated with prognosis.The quantitative analysis of aEEG can facilitate interpretation in electroencephalogram of HIE neonates,thereby laying foundation to the development of automated neonatal electroencephalogram analysis technique.

Key words: hypoxic ischaemic encephalopathy, amplitude-integrated electroencephalogram, quantitative analysis, developmental quotient, neonates