定量脑电图对大脑中动脉闭塞性脑梗死侧支循环及预后的评估价值

朱英标; 官常荣; 吕锦; 陈伟康; 李洁; 蓝丽康

doi:10.16766/j.cnki.issn.1674-4152.003343

定量脑电图对大脑中动脉闭塞性脑梗死侧支循环及预后的评估价值

doi: 10.16766/j.cnki.issn.1674-4152.003343

1.
温州医科大学附属第六医院神经内科，浙江丽水 323000
2.
温州医科大学附属第六医院内分泌科

基金项目:

浙江省医药卫生科技计划项目 2021KY1233

详细信息

通讯作者:
朱英标，E-mail: zybiao5107@163.com

中图分类号: R743 R741.044
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- 文章访问数: 180
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- 被引次数: 0
出版历程
- 收稿日期: 2023-07-22
- 网络出版日期: 2024-03-09

The value of quantitative electroencephalography in assessing collateral circulation and prognosis in middle cerebral artery occlusive cerebral infarction

1.
Department of Neurology, the Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang 323000, China

摘要

摘要: 目的分析脑梗死患者脑电图(EEG)指数的变化，探讨定量脑电图对大脑中动脉闭塞性脑梗死侧支循环及预后的评估价值。方法选择2020年6月—2022年12月在丽水市人民医院神经内科就诊，经影像证实为大脑中动脉闭塞性脑梗死患者78例。在发病72 h内完成EEG、多时相计算机体层血管成像(mCTA)和美国国立卫生院卒中量表(NIHSS)评分，在发病后3个月完成改良Barthel指数量表(MBI)评分。侧支循环评估采用mCTA ASITN/SIR侧支循环评估系统。通过Pearson法对EEG指数与mCTA ASITN/SIR评分、NIHSS评分及MBI评分进行相关性分析。结果 EEG指数δ/α功率比(DAR)、(θ+δ)/(α+β)功率比(DTABR)、配对衍生脑对称指数(pdBSI)与ASITN/SIR评分(r=-0.734、-0.747、-0.759，P＜0.01)、MBI评分(r=-0.802、-0.810、-0.853，P＜0.01)均呈负相关关系，与NIHSS评分(r=0.876、0.875、0.813，P＜0.01)均呈正相关关系。预后不良组EEG指数DAR(t=6.374, P＜0.001)、DTABR(t=6.575, P＜0.001)、pdBSI(t=9.171, P＜0.001)高于预后良好组。ROC曲线分析显示, EEG指数DAR、DTABR、pdBSI对不良结局发生风险均有较高的预测价值(AUC>0.87)。结论定量脑电图能有效评估大脑中动脉闭塞性脑梗死神经损伤严重程度和侧支循环，对于3个月神经功能预后也有较好的预测价值。
- 定量脑电图 /
- 缺血性脑卒中 /
- 侧支循环 /
- 预后 /
- 评估
Abstract: Objective To analyze the changes of electroencephalogram (EEG) indices in patients with cerebral infarction and to explore the value of quantitative EEG on collateral circulation and prognosis of middle cerebral artery occlusive cerebral infarction. Methods Seventy-eight patients with imaging-confirmed middle cerebral artery occlusive stroke who were seen at the Department of Neurology, Lishui People's Hospital between June 2020 and December 2022 were selected. EEG, multitemporal CTA (mCTA), and NIHSS score were completed within 72 hours of onset. MBI scores were completed 3 months after onset. Collateral circulation was assessed using the mCTA ASITN/SIR-based collateral circulation assessment system. Correlation of EEG indices with mCTA ASITN/SIR-based collateral circulation scores, NIHSS scores, and MBI scores was assessed by Pearson correlation analysis. Results The EEG indices DAR, DTABR and pdBSI were negatively correlated with ASITN/SIR collateral circulation scores (r=-0.734, -0.747, -0.759; P < 0.01), MBI scores (r=-0.802, -0.810, -0.853; P < 0.01) and positively correlated with NIHSS scores (r=0.876, 0.875, 0.813; P < 0.01). The EEG indices DAR (t=6.374, P < 0.001), DTABR (t=6.575, P < 0.001) and pdBSI (t=9.171, P < 0.001) were higher in the poor prognosis group than in the good prognosis group. ROC curve analysis showed that the EEG indices DAR, DTABR and pdBSI all had high predictive value for the risk of patients developing adverse outcomes in patients (AUC>0.87). Conclusion Quantitative EEG can effectively assess the severity of middle cerebral artery occlusive stroke and collateral circulation, and also has a good predictive value for 3-month neurological prognosis.
- Quantitative electroencephalography /
- Ischemic stroke /
- Collateral circulation /
- Assessment /

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图 1 EEG指数预测AIS不良结局的ROC曲线

Figure 1. ROC curve of the EEG index for predicting adverse outcomes in AIS

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表 1 EEG指数与mCTA ASITN/SIR、NIHSS、MBI的相关性

Table 1. Correlation of EEG indices with mCTA ASITN/SIR, NIHSS, and MBI

EEG指数	中位数(区间)^a	Pearson相关系数(r值)^b
EEG指数	中位数(区间)^a	mCTA ASITN/SIR	NIHSS	MBI
DAR	3.17(0.81~15.21)	-0.734	0.876	-0.802
DTABR	2.95(0.78~13.84)	-0.747	0.875	-0.810
pdBSI	0.25(0.02~0.67)	-0.759	0.813	-0.853
注：^a括号内表示最小值到最大值。^b均P＜0.001。

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表 2 不同预后AIS患者EEG指数比较(x±s)

Table 2. Comparison of EEG index in AIS patients with different prognosis(x±s)

组别	例数	DAR	DTABR	pdBSI
MBI≤60分	29	5.99±2.76	5.52±2.49	0.38±0.10
MBI>60分	49	2.57±1.14	2.32±1.07	0.19±0.08
t值		6.374	6.575	9.171
P值		＜0.001	＜0.001	＜0.001

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表 3 EEG指数对AIS不良结局的预测价值

Table 3. Predictive value of the EEG index for adverse outcomes in AIS

EEG指数	AUC	95% CI	SE	P值
DAR	0.927	0.873~0.981	0.028	＜0.001
DTABR	0.935	0.884~0.985	0.026	＜0.001
pdBSI	0.940	0.881~1.000	0.030	＜0.001

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