正常早产儿振幅整合脑电图特点的研究

目的 了解28 ～ 36周正常早产儿出生时振幅整合脑电图(Amplitude integrated Electroencephalogram,aEEG)特征，为早产儿临床脑功能监测提供依据。方法 共纳入胎龄28～ 36周早产儿135例，采用国产数字化振幅整合脑功能监护仪（CFM3000，样机）分别于生后3d内进行监测，每次连续监测4h。分析正常28～36周早产儿aEEG背景连续性、睡眠-觉醒周期（周期性）、电压和带宽。结果 连续性电压由28周的30％增加至36周时的85.7％(x2=28.2，P=0.026)。睡眠-觉醒周期出现率由28周的10％增加至36周时的100％( x2=192.4，P＜0.01)。窄带下界电压由28周的(6.8±1.7) μV升至35～36周的9.7～10.1 μV(F=11.4，P＜0.01)。窄带带宽由28周的(21.3 ±8.3)μV降至36周的(14.9±7.5) μV(F =8.731，P=0.000)。aEEG连续性、周期性、窄带带宽和总评分与胎龄的相关系数分别为0.32、0.81、0.55和0.78，P均＜0.05，窄带下界电压（μV）与胎龄的相关系数为0.38,P＜ 0.05。结论出生时胎龄越大，aEEG越成熟，表现为aEEG图形的连续性、睡眠-觉醒周期渐趋明显，窄带下界电压逐渐升高，带宽变窄。

Amplitude integrated electroencephalography characteristics of normal preterm newborns: a muiticenter clinical study

Objective To study the characteristics of amplitude integrated electroencephalography (aEEG) in preterm infants and changes of maturation with gestational age. Methods aEEG monitoring was done within 3 days of age with domestically produced digital aEEG set (CFM3000). Duration of each recording was at least 4 hours. The continuty, sleep-wake cycle, voltage and bandwidth of all aEEG tracing were analyzed. Results The percent of continuity background increased from 30％ of 28 weeks to 85.7％of 36 weeks ( x2 =28.2, P =0. 026 ) ; the percent of mature sleep-wake cycle increased from 10％ of 28 weeks to 100％ of 36 weeks ( x2 =192.4,P ＜0. 01 ). Low bound voltage increased with gestational age,from (6.8 ± 1.7)μV(28 w) to9.7-10. 1 μV(35-36 w) (F=11.4, P＜0. 01). Bandwidth of the narrow band decreases gradually with gestational age, from 1.45 cm (28 w) to (0. 86 ± 0. 24) cm (36 w) (F=8. 731, P ＜ 0. 01 ). The correlation coefficient for continuity, sleep - wake cycle, low bound voltage and bandwidth of narrow band, and total scores were 0. 32, 0. 81, 0. 38, 0. 55 and 0. 78 respectively ( P ＜0. 05 ). Conclusion The older the gestational age of infants at birth, the more mature the aEEG pattern, manifested as increased continuity and sleep-wake cycle, the higher low bound voltage and more narrowed bandwidth with increased gestational age.