定量脑电图对缺血性脑卒中溶栓后脑出血患者神经功能和短期预后的评估价值
Value of quantitative electroencephalogram in evaluating neurological function and short-term prognosis in patients with cerebral hemorrhage after thrombolysis for ischemic stroke
宋璐 1程群2
作者信息
- 1. 温州医科大学附属衢州医院/衢州市人民医院 神经电生理室,浙江 衢州 324000
- 2. 温州医科大学附属衢州医院/衢州市人民医院 麻醉科,浙江 衢州 324000
- 折叠
摘要
目的 分析定量脑电图(quantitative electroencephalogram,qEEG)对溶栓后脑出血患者的神经功能和短期预后的评估价值,为临床诊疗提供参考.方法 回顾 200 例接受溶栓治疗的急性缺血性脑卒中患者病历资料,根据改良Rankin量表评分将患者分为预后良好组(153 例)和预后不良组(47 例).比较 2 组患者的基线资料、qEEG指标、美国国立卫生研究院卒中量表(NIHSS)评分;Pearson法分析qEEG指标与缺血性脑卒中溶栓后脑出血患者神经功能的相关性,Logistic回归分析导致溶栓后脑出血患者预后不良的危险因素,ROC分析其预测价值.结果 溶栓后 24 h,预后良好组脑对称指数(BSI)、脑电图慢波化比率(DTABR)及NIHSS评分均低于预后不良组,差异有统计学意义(P<0.05).预后不良患者的BSI、DTABR与NIHSS评分呈明显正相关(r=0.819、0.673,均P<0.001),BSI、DTABR升高是导致患者预后不良的独立危险因素(P<0.05).BSI、DTABR联合预测溶栓后脑出血患者预后的曲线下面积(AUC)为 0.956,高于单独指标(Z=2.997、3.034,均 P<0.05),敏感度为 100.00%,特异度为77.92%.结论 qEEG可用于评估缺血性脑卒中溶栓后脑出血患者的神经功能,BSI和DTABR联合检测可有效预测患者短期预后.
Abstract
Objective To analyze the value of quantitative electroencephalogram(qEEG)in assessing neurological function and short-term prognosis in patients with cerebral hemorrhage after thrombolysis so as to provide reference for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on the medical records of 200 patients with acute ischemic stroke who underwent thrombolytic therapy.Patients were categorized into two groups based on modified Rankin scale score:the good prognosis group(153 cases)and the poor prognosis group(47 cases).Baseline data,qEEG indicators,and the National institutes of health stroke scale(NIHSS)scores of the two groups were compared.Pearson's method was used to analyze the correlation between qEEG indicators and neurological function in patients with post-thrombolysis cerebral hemorrhage for ischemic stroke.Logistic regression analysis was conducted to screen the risk factors for poor prognosis in patients with cerebral hemorrhage after thrombolysis,and the predictive value was analyzed using ROC curves.Results At 24 hours post-thrombolysis,the brain symmetry index(BSI),delta-theta activity to beta activity ratio(DTABR),and NIHSS scores were significantly lower in the good prognosis group compared to the poor prognosis group(P<0.05).BSI and DTABR were positively correlated with NIHSS score in the poor prognosis group(both P<0.05).Elevated BSI and DTABR wereidentified as independent risk factors for poor prognosis(P<0.05).The area under the curve(AUC)for the combined prediction of BSI and DTABR for post-thrombolysis cerebral hemorrhage prognosis was 0.956,which was higher than that of the individual indicators(Z=2.997,3.034,respectively,both P<0.05),with a sensitivity of 100.00%and a specificity of 77.92%.Conclusions BSI and DTABR can be used to evaluate neurological function in patients with cerebral hemorrhage after thrombolysis for ischemic stroke,and their combined assessment can effectively predict the short-term prognosis of these patients.
关键词
定量脑电图/缺血性脑卒中/溶栓后脑出血/神经功能/短期预后Key words
quantitative electroencephalogram/ischemic stroke/post-thrombolysis cerebral hemorrhage/neurological function/short-term prognosis引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据