振幅整合脑电图联合炎症指标对宫内感染继发脑损伤的预测价值分析

Amplitude-Integrated Electroencephalogram Combined with Inflammatory Markers in the Diagnosis of Secondary Intrauterine Infection Analysis of Predictive Value of Brain Injury

摘要: 目的：探讨振幅整合脑电图(amplitude-integrated electroencephalogram, aEEG)联合炎症指标对宫内感染继发早产儿脑损伤的预测价值。方法：选取2019年7月~2023年10月在泰安市中心医院新生儿监护室住院的87例胎龄为28~32周脑损伤早产儿，根据宫内感染诊断标准，分为宫内感染组和非宫内感染组，收集早产儿振幅整合脑电图及生后12 h内静脉血WBC、CRP、PCT、SAA等临床资料，采用Burdjalov早产儿脑功能评分系统对aEEG进行评分，以单因素分析及多因素Logistic回归分析其组间差异。结果：纳入的87例脑损伤早产儿中，宫内感染患儿66例(75.9%)，非宫内感染患儿21例(24.1%)。单因素分析显示WBC、CRP、PCT、SAA在宫内感染组中显著升高，差异有统计学意义；aEEG评分在宫内感染组中显著降低，差异有统计学意义。多因素Logistic回归分析结果显示：aEEG评分是宫内感染早产儿脑损伤的独立保护因素，血指标PCT是宫内感染早产儿脑损伤的独立危险因素。结论：血液炎症指标升高以及aEEG脑功能评分减低，均对宫内感染继发早产儿脑损伤有较好的评估价值，血液炎症指标联合aEEG评分对宫内感染早产儿脑损伤的风险预测价值优于炎症指标或aEEG单项评估。

Abstract: Objective: To evaluate the predictive value of amplitude-integrated electroencephalogram (aEEG) combined with inflammatory markers in premature infants with intrauterine infection. Methods: From July 2019 to October 2023, 87 premature infants with cerebral injury with gestational age of 28~32 weeks were selected and hospitalized in Tai’an Neonatal Intensive Care Unit. According to the diagnostic criteria of intrauterine infection, they were divided into intrauterine infection group and non-intrauterine infection group. The clinical data of amplitude integrated EEG, WBC, CRP, PCT and SAA in 12 hours after birth were collected. The aEEG was scored by Burdjalov Preterm Infant Cerebral Function Scale. Univariate analysis and multivariate logistic regression analysis were used. Results: Among 87 premature infants, 66 (75.9%) were intrauterine infected and 21 (24.1%) were non-intrauterine infected. Univariate analysis showed that WBC, CRP, PCT and SAA were significantly increased in intrauterine infection group, and the difference was significant in general study. The aEEG score was significantly lower in intrauterine infection group, and the difference was significant. Multivariate Logistic regression analysis showed that aEEG score was an independent predictor of cerebral injury in premature infants with intrauterine infection, and PCT was an independent predictor of cerebral injury in premature infants with intrauterine infection. Conclusion: Both elevated blood inflammatory markers and reduced aEEG brain function score have a good predictive value for brain injury of premature infant with intrauterine infection. The combined use of blood inflammatory markers and aEEG score is superior to single assessment of inflammation markers or aEEG in predicting brain injury of premature infant with intrauterine infection.