视频脑电图在急性缺血性脑卒中患者近期预后评估中的应用

Application of video electroencephalogram in evaluation of short-term prognosis in patients with acute ischemic stroke

  • 摘要:
      目的  探讨视频脑电图(VEEG)在急性缺血性脑卒中患者预后评估中的价值。
      方法  选取85例急性缺血性脑卒中患者为研究对象, 均行床旁VEEG监测,收集患者的临床资料并采用改良Rankin量表(mRS)评估患者发病3个月后的预后情况。
      结果  预后不良组患者的入院美国国立卫生研究院卒中量表(NIHSS)评分、大脑对称指数(BSI)、波形比率(DTABR)高于预后良好组,而VEEG分级中Ⅰ级+Ⅱ级的占比低于预后良好组,差异有统计学意义(P < 0.05或P < 0.01); VEEG分级、BSI和DTABR与入院NIHSS评分、mRS评分均呈显著正相关,且入院NIHSS评分与mRS评分亦呈显著正相关(P < 0.01)。受试者工作曲线(ROC)分析显示,BSI和DTABR评估预后的敏感性显著高于NIHSS评分。Logistic多因素回归分析发现,BSI和DTABR是脑卒中预后的独立影响因素, BSI和DTABR值越高,预后不良的风险越高。
      结论  VEEG的量化指标BSI和DTABR能够有效评估患者的预后改善情况,可以作为预后的独立预测指标。

     

    Abstract:
      Objective  To explore the value of video electroencephalography(VEEG) in evaluation of clinical prognosis of the patients with acute ischemic stroke(AIS).
      Methods  A total of 85 patients with AIS treated in our hospital were selected as objects. All patients were performed VEEG examination at 24 h of admission, and the clinical data were collected. The clinical prognosis condition after 3 months were evaluated by modified Rankin scale(mRS).
      Results  The poor prognosis group had higher results in the National Institutes of Health Stroke Scale(NIHSS) score, brain symmetry index(BSI), wave ratio of(δ+θ)to(α+β)(DTABR) than good prognosis group, while proportion of gradeⅠand Ⅱ by VEEG grading were lower than that in good prognosis group(P < 0.05 or P < 0.01). BSI, DTABR, VEEG grading were positively correlated with NIHSS score and mRS score, and NIHSS score was also positively correlated with mRS score. ROC curve analysis showed that the sensitivities of BSI and DTABR in evaluating prognosis were higher than that of NIHSS score(P < 0.05). BSI and DTABR were independent influencing factors for the prognosis of stroke. The higher value of BSI and DTABR was, the higher the risk of poor prognosis would be.
      Conclusion  Quantitative indicators such as VEEG BSI and DTABR could effectively assess the prognosis of patients, and may be as independent prognostic indicators.

     

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