新疆医科大学学报

目的研究重度缺血性脑卒中患者脑电图相对波段特征与重症缺血性卒中预后的关系。方法回顾性分析2020年5月-2021年5月秦皇岛军工医院神经内科收治的40例预后良好(预后良好组)与40例预后不良(预后不良组)的重症缺血性脑卒中患者的临床资料,对比两组患者脑电图相对波段指标参数[大脑对称指数(BSI)、波形比率(DTABR)],分析指标参数对重症缺血性脑卒中患者预后的预测价值。采用Rankin量表(mRS)评估重症缺血性脑卒中患者的预后效果,绘制受试者工作曲线(ROC),得到曲线下面积(AUC),检验重症缺血性脑卒中患者脑电图相对波段指标对患者预后的预测效能。结果与预后良好组比较,预后不良组患者年龄、体质指数、性别、合并症(糖尿病、高血压、高血脂)、病灶分布对比,差异无统计学意义(P>0.05);预后不良组患者BSI、DTABR与Rankin量表评分均较高,差异有统计学意义(P<0.05)。双变量Pearson直线相关性检验结果显示,脑电图相对波段指标参数BSI、DTABR与Rankin量表评分均呈相关性(r>0,P<0.05)。将重症缺血性脑卒中患者预后情况作为状态变量,患者脑电图相对波段指标参数作为检验变量,绘制受试者ROC曲线结果显示,重症缺血性脑卒中患者脑电图相对波段指标参数(BSI、DTABR、BSI+DTABR)预测患者预后不良的AUC分别为0.895、0.837、0.912,AUC均>0.80,当cut-off值分别取0.103、0.685时可获得最佳的预测效能。结论重症缺血性脑卒中患者的脑电图相对波段参数与患者预后密切相关,临床可依据脑电图相对波段参数变化预判重症缺血性脑卒中患者的预后情况,对指导早期重症缺血性脑卒中患者的病情及预后具有积极意义。

Objective To observe the EEG and prognosis of patients with severe ischemic stroke(IS) and to analyze the relationship between them, as well as promote a favorable prognosis in patients with severe IS. Methods The relationship between the relative waveform characteristics of EEG and the prognosis of severe IS in the patients was analyzed.The clinical data of 40 patients with severe IS admitted to the Department of Neurology of Qinhuangdao Military Hospi-tal from May 2020 to May 2021 with good prognosis(good prognosis group) and 40 patients with poor prognosis(poorprognosis group) were retrospectively analyzed, and the EEG relative waveform index parameters [brain symmetry in-dex(BSI), waveform ratio(DTABR)] were compared between the two groups. The prognostic value of the parameters onthe prognosis of them was assessed using the Rankin Scale(m RS), and the area under the curve(AUC) was obtained byplotting the subject operating curve(ROC) to test the predictive efficacy of EEG relative waveform indexes on the prog-nosis of them. Results There was no statistically significant difference in age, body mass index, gender, comorbidities(diabetes, hypertension, hyperlipidemia), and lesion distribution in the poor prognosis group compared with the goodprognosis group(P > 0.05); the BSI, DTABR and Rankin Scale scores were higher in the poor prognosis group, with sta-tistically significant differences(P < 0.05). The results showed that the EEG relative band index parameters BSI,DTA-BR and Rankin scale scores were all correlated(r > 0,P < 0.05). The prognosis of patients with severe IS was used asthe status variable, and the EEG relative band index parameters were used as the test variables. The results of plottingthe ROC curves of the subjects showed that the EEG relative band index parameters(BSI, DTABR and Rankin scalescores) of patients with severe IS were 0.895, 0.837 and 0.912 respectively, with AUCs >0.80. The higher the EEG rel-ative band parameters, which was the worst prognosis of the patients. Conclusion The EEG relative band parametersof the patients with severe IS were closely related to the prognosis of patients. Clinically, the prognosis of patients withsevere IS can be predicted, according to the changes of EEG relative band parameters, which is of importance in guid-ing the condition and prognosis of patients with early severe IS.