Value of amplitude-integrated electroencephalography in monitoring acute period of neonatal bilirubin encephalopathy and prognostic assessment
XIA Yao-fang1, YANG Juan1, TIAN Bao-li2, LIUCui-qing11
1.Department of Neonatology, Children's Hospital of Hebei Province, Hebei, Shijiazhuang 050031, China; 2.Department of Neonatology, HanDan Center Hospital, Hebei, Handan 056001, China
Abstract: Objective To investigate the value of amplitude-integrated electroencephalography (aEEG) in monitoring early stage of neonatal acute bilirubin encephalopathy and prognostic assessment. Methods From January 2014 to January 2016, 208 cases of full-term newborns who were admitted to Department of Neonatology in Children's Hospital of Hebei Province or HanDan Center Hospital with serum total bilirubin (TBil)﹥ 300 μmol/L were included. They were divided into bilirubin encephalopathy group (72 cases) and non-bilirubin encephalopathy group (136 cases, who were not diagnosed as bilirubin encephalopathy). All the cases undergone aEEG inspection, MRI inspection and bilirubin induced nerve dysfunction (BIND) scaling. Phone or outpatient follow-up and evaluation of neurological development were carried out in discharged infants with 3 months of age. Statistical analysis was performed by independent sample t test, χ2 test, and Spearman rank correlation analysis. Results There were no statistically significant between bilirubin encephalopathy group and non-bilirubin encephalopathy group in constituent ratio of causes, sex ratio, gestational age, day-age at appearance of jaundice and day-age at admission (all P﹥0.05). Serum TBil of two groups were (427±67) and (358±50) μmol/L (t=2.730); abnormal rate of aEEG were 76.4% (55/72) and 55.1% (75/136) (χ2=9.063); abnormal rate of MRI were 69.4% (50/72) and 0.0% (0/136) (χ2=124.330). The above indexes in bilirubin encephalopathy group were higher than those in non-bilirubin encephalopathy group (all P﹤0.01). The result of aEEG was positively correlated with clinical stages of bilirubin encephalopathy (warning period, cramps period, recovery period) (r=0.515，P=0.000), BIND score (r=0.508, P=0.000) and MRI result (r=0.668, P =0.000). All the 34 cases with severe abnormal result of aEEG were bilirubin encephalopathy. Conclusions The result of aEEG is correlated with clinical stages of bilirubin encephalopathy, BIND grading and MRI result, which can be used for monitoring cerebral function of acute phase of bilirubin encephalopathy and has some value for assessment of clinical prognosis.
夏耀方, 杨娟, 田宝丽, 等. 振幅整合脑电图在新生儿胆红素脑病急性期监测及预后评估中的价值[J]. 发育医学电子杂志, 2017, 5(3): 159-163.
XIA Yao-fang, YANG Juan , TIAN Bao-li, et al. Value of amplitude-integrated electroencephalography in monitoring acute period of neonatal bilirubin encephalopathy and prognostic assessment. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 159-163.
2017, Vol. 5 
