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
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References
[1] Lawn JE,CousensS,ZupanJ.4 million neonatal deaths:when Where Why[J].Lancet,2005,365(19462):891-900.
[2] Schumacher EM,Westvik AS,Larsson PG,et al.Feasibility of long-term continues EEG monitoring during the first days of life in preterm infants:an automated quantification of the EEG Activity[J].Pediatr Res,2011,69(5):413-417.
[3] 中华医学会儿科学分会新生儿学组.新生儿缺氧缺血性脑病诊断标准[J].中华儿科杂志,2005,43(8):584.
[4] 刘晓燕.临床脑电图学[M].北京:人民卫生出版社,2006.
[5] Clancy RR,Dicker L,Cho S,et al.Robert R,Clancy,Lee DickeR,et al.Agreeement between long-term neonatal background classification by conventional and Amplitude-integrated EEG[J].J Clin Neurophysiol,2011,28(1):1-9.
[6] Jiang ZD,Brosi DM,Wang J,et al.Time course of brainsterm pathophysiology during first month in term infants after perinatal asphyxia.Revealed by MLS BAEP latencies and intervals[J].Pediatr Res,2003,54(5):680-687.
[7] Boylan GB,Murray DM,Rennie JM.The normal EEG and aEEG[M]//Rennie JM,Hagmann CF,Robertson NJ,Neonatal cerebral investigation.Cambridge:Cambridge University Press,2008:83-91.
[8] Amam I,Ozek E,Kulekci S,et al.Auditory neuropathy in hyperbilirubinemia:is there a correlation between serum bilirubin,neuron,specific enolase levels and auditory neuropathy?[J].Int J Audiol,2004,43 (9):516-522.
[9] 王跑球,张惠佳,覃蓉,等.Peabody 运动发育量表-2与Gesell发育量表在脑性瘫痪患儿中的平行效度研究[J].中华物理医学与康复杂志,2009,31(7):452-455.
[10]Niemarkt HJ,Andriessen P,Pasman J,et al.Analyzing EEG maturation in preterm infants:the value of a quantitative approach[J].J Neonatal Perinatal Med,2009,1:131-144.
[11]Löfhede J,Thordstein M,Löfgren N,et al.Automatic classification of background EEG activity in healthy and sick neonates[J].Neural Eng,2010,7(1):16007.
[12]Biagioni E,Bartalena L,Bold rini A,et al.Background EEG activity in preterm infants:correlation of outcome with selected maturational features[J].Electroencephalogr Clin Neurophysiol,1994,91(3):154-162.
[13]Korotchikova I,Stevenson NJ,Walsh BH,et al.Quantitative EEG analysis in neonatal hypoxic ischaemic encephalopathy[J].Clin Neurophysiol,2011,122(8):1671-1678
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