CAJ | 학술논문

目的探讨早产小于胎龄儿(SGA)与适于胎龄儿(AGA)在振幅整合脑电图(aEEG)图形评分上的差异.方法选择2013年3月至2014年2月入住广东医学院附属医院儿童医学中心新生儿重症监护室的早产儿139例,符合纳入标准的32～36周的早产儿114例,其中SGA组54例,AGA组60例.采用Nico-letOne脑功能监护仪,均于出生3d内进行监测,每次连续监测至少3h.运用早产儿aEEG评分系统,对比分析2组早产儿在aEEG图形连续性、睡眠-觉醒周期、下边界振幅、带宽和总评分各参数分值间的差异.结果 1.随着出生胎龄的增加,SGA组aEEG图形的连续性、睡眠-觉醒周期、下边界振幅、带宽和总评分分值均逐渐增加,不同胎龄组间的差异有统计学意义(P均＜0.05);AGA组aEEG图形睡眠-觉醒周期、带宽和总评分也逐渐增加,不同胎龄组间比较差异均有统计学意义(P均＜0.05),但连续性、下边界振幅其不同胎龄组间的差异均无统计学意义(P均＞0.05).2.SGA组连续性、睡眠-觉醒周期、下边界振幅、带宽和总评分均与出生胎龄有相关性(r=0.438、0.597、0.385、0.606、0.608,P均＜0.05);AGA组睡眠-觉醒周期、带宽和总评分与出生胎龄有相关性(r=0.528、0.615、0.635,P均＜0.05).3.相同出生胎龄下,SGA组在带宽评分和总评分方面落后于AGA组.结论睡眠-觉醒周期、带宽和总评分均可作为早产SGA与AGA脑成熟度的评估指标,而相同出生胎龄下,SGA在带宽和总评分方面的落后可能与其神经发育迟缓有关.
목적 탐토조산소우태령인(SGA)여괄우태령인(AGA)재진폭정합뇌전도(aEEG)도형평분상적차이.방법 선택2013년3월지2014년2월입주엄동의학원부속의원인동의학중심신생인중증감호실적조산인139례,부합납입표준적32～36주적조산인114례,기중SGA조54례,AGA조60례.채용Nico-letOne뇌공능감호의,균우출생3d내진행감측,매차련속감측지소3h.운용조산인aEEG평분계통,대비분석2조조산인재aEEG도형련속성、수면-각성주기、하변계진폭、대관화총평분각삼수분치간적차이.결과 1.수착출생태령적증가,SGA조aEEG도형적련속성、수면-각성주기、하변계진폭、대관화총평분분치균축점증가,불동태령조간적차이유통계학의의(P균＜0.05);AGA조aEEG도형수면-각성주기、대관화총평분야축점증가,불동태령조간비교차이균유통계학의의(P균＜0.05),단련속성、하변계진폭기불동태령조간적차이균무통계학의의(P균＞0.05).2.SGA조련속성、수면-각성주기、하변계진폭、대관화총평분균여출생태령유상관성(r=0.438、0.597、0.385、0.606、0.608,P균＜0.05);AGA조수면-각성주기、대관화총평분여출생태령유상관성(r=0.528、0.615、0.635,P균＜0.05).3.상동출생태령하,SGA조재대관평분화총평분방면락후우AGA조.결론 수면-각성주기、대관화총평분균가작위조산SGA여AGA뇌성숙도적평고지표,이상동출생태령하,SGA재대관화총평분방면적락후가능여기신경발육지완유관.
Objective To compare the scores of amplitude-integrated electroencephalogram (aEEG) tracings between preterm infants who were smaller for gestational age (SGA) and those who were appropriate for gestation (AGA).Methods A total of 139 preterm infants were collected in the Neonatal Intensive Care Unit of the Affiliated Hospital of Guangdong Medical College during the period of Mar.2013 to Feb.2014.One hundred and fourteen patients met the inclusion criteria with gestational ages from 32 to 36 weeks at birth,including 54 SGA infants and 60 AGA infants.The aEEG recordings were obtained within 72 h after birth by using the NicoletOne monitor.Duration of each recording was at least 3 h.Five aspects of each tracing,such as continuity (Co),sleep-wake cycling (Cy),amplitude of the lower border (LB),bandwidth (B) and total maturation scores,were evaluated and compared between 2 groups by applying a aEEG scoring system.Results 1.As SGA infants,scores for Co,Cy,LB,B as well as total maturation scores were progressively increased with gestational age advancing(all P ＜ 0.05).As AGA infants,scores for Cy,B and total maturation scores progressively increased with advancing gestational age (all P ＜ 0.05),but there were no statistical differences between each gestational ages in Co,LB scores (all P ＞ 0.05).2.Linear regression analysis of SGA infants' gestational age to Co,Cy,LB,B and total maturation scores showed positively correlation,and the correlation coefficients were 0.438,0.597,0.385,0.606 and 0.608,respectively (all P ＜ 0.05).As AGA infants,a positive correlation between gestational age and Cy,B as well as total maturation scores were observed,and the correlation coefficients were 0.528,0.615 and 0.635,respectively (all P ＜ 0.05).3.At the same gestational age,both the B scores and total maturation scores in SGA group were lower than those in AGA group.Conclusions SGA and AGA,Co,Cy and total maturation scores can be used to evaluate the maturation of cerebral function.At the same gestational age,the scores of B and total maturation scores are lower in the SGA,and this might be associated with their delayed neuromotor development.