摘要目的 研究振幅整合脑电图(amplitude integrated electroencephalogram,aEEG)对新生儿惊厥的评价意义.方法 对2008年7月至2009年7月于北京大学第一医院新生儿病房收治的32例新生儿惊厥患儿在同一天进行aEEG与视频脑电图(video electroencephalogram,VEEG)监测,分析aEEG脑电振幅波谱带、脑电背景节律及原始脑电信号,并与VEEG结果 进行对比.结果 有12例患儿在VEEG监测过程中有临床惊厥发作,在aEEG中均监测到,监测敏感性达100%;VEEG表现为发作间期放电的20例,aEEG监测的敏感性87%,特异性100%,阳性预测值100%,阴性预测值80%,但aEEG不能区分发作期放电或者发作间期放电.VEEG监测中背景活动异常的13例患儿,aEEG监测的敏感性100%,特异性83%,阳性预测值76%,阴性预测值100%.32例患儿在VEEG监测中均可见发作期或发作间期痫样放电,而aEEG的原始脑电亦能监测到,有3例患儿在aEEG整合后振幅波谱带中未监测到放电,但在原始脑电中能监测到.结论 aEEG对新生儿惊厥监测的敏感性和特异性比较理想,可以作为一种简单、可靠的新生儿惊厥的初步筛查方法.

abstractsObjective To study the evaluative values of amplitude integrated electroencephalogram (aEEG) in screening neonatal seizures.Methods The aEEG and video electroencephalogram (VEEG) on 32 patients with seizures hospitalized in Peking University First Hospital was conducted on the same day.The parameters of aEEG including the integrated spectra band,background rhythm and primitive electro signal were analyzed and compared with VEEG.Results Seizures presented clinically by 12 cases were detected by VEEG,and their electric discharges were detected by aEEG.The sensitivity of aEEG was 100%.VEEG showed electric discharges during intermediate stage in twenty cases and thus the seventeen of this group were detected by aEEG with its sensitivity of 87% and 100% in the specificity.The positive and negative predictive values of aEEG were 80% and 100%,respectively.But aEEG could not discriminate the attack stage or intermediate stage electric discharges.The abnormal background activity was detected by VEEG in 13 cases and the sensitivity of aEEG was 100% and the specificity was 83%.The positive and negative predictive value by aEEG were 76% and 100% respectively.The electric discharges of 32 cases were detected by VEEG whenever they were in attack stage or intermediate stage.All electric discharges could be detected through primitive electro signal by aEEG.The electric discharges in 3 cases were not detected by integrated spectra band from aEEG,but were detected by primitive electro signal from aEEG.Conclusions The sensitivity and specificity in the screening of neonatal seizures by aEEG is useful and could be applied clinically as a simple and safe screening method for recognizing neonatal seizures.