Application Of Amplitude-Integrated Electroencephalogram Combined With Craniocerebral Ultrasound In Preterm Infants

ObjectivesTo plumb the application value of amplitude-integrated electroencephalogram combined with craniocerebral ultrasound in the evaluation of brain development in premature infants.MethodsThe research targets of this investigation were preterm infants born at The NO.2Affiliated Hospital of Guangzhou Medical University from January 1,2022 to 2023 February 28,and shifted to neonatal intensive care unit within 1 hour after birth,as well as hospitalized term infants hospitalized in a general neonatal ward during the same period,excluded with the system of congenital malformation,genetic metabolism related diseases,midway withdrawal,lack of data of the newborn.Bedside amplitude-integrated electroencephalogram and craniocerebral ultrasound performed the study subjects within 1 week of birth,And take the gestational age at birth as the main group basis,Divided into Group A(small preterm infant group,Gestational age <34 W),Group B(near-term children group,34 W birth for gestational age <37 W),Group C(full-term child group,Gestational age at birth,37 W),In addition,according to the head MR findings at 37 weeks of corrected gestational age,newborns with anatomical abnormalities will be included in Group D(MR abnormal group)alone,Collect perinatal-related clinical data for each newborn,A retrospective cohort study of the enrolled neonates,To compare the effects of gestational ages on amplitude-integrated electroencephalogram and craniocerebral ultrasound inspection results;Explore the affecting elements of the two inspection measures;Compare the relationship between the two examinations;To explore the value of two inspection measures for estimating brain development in preterm infants.Results1.The relationship between gestational age and amplitude-integrated electroencephalogram: As gestational age increases,the score of the burdjalov integrated EEG was higher(P <0.05);for the same subject,the original score was higher than the original branch in the pillow area,with a strong positive correlation(r=0.928> 0.5,P <0.01),the absolute score was lower than the pillow area,and a strong positive correlation(r=0.801> 0.5,P <0.01).2.The relationship between gestational age and cerebral artery blood mechanics parameters: With gestational age,the resistance index value of bilateral middle cerebral arteries lessened(P <0.05).The peak systolic velocity raised(P <0.05),the end diastolic velocity grown(P <0.05),and the peak systolic / end diastolic velocity ratio decreased(P <0.05).The peak systolic velocity and end-diastolic velocity of the middle cerebral artery have certain diagnostic value in the judgment of neonatal term.3.Amplitude-integrated electroencephalogram combined with craniocerebral ultrasound is used to assess brain development: the original score of central area,occipital area and central district correction score were used to indicate the degree of EEG functional maturity,The absolute value of the correlation coefficient with the correction score of central area is the largest(r=0.757> 0.583> 0.422);The resistance index of the anterior cerebral artery and bilateral middle cerebral arteries was used as an index to assess blood perfusion in cerebral tissue,With the largest resistance index correlation coefficient in the left middle cerebral artery(r=0.696> 0.487> 0.129),And found a moderate positive correlation between the two groups of indicators(r=0.447>0.3,P=0.019<0.05).4.Influence of potassium ion and sodium ion on amplitude-integrated electroencephalogram: Outcomes of this study found a positive correlation between potassium and sodium concentration levels in serum and amplitude-integrated electroencephalogram test scores(r potassium =0.261> 0.1,P potassium =0.036 <0.05;r sodium =0.463> 0.3,P sodium <0.01).5.The relationship between anemia and cerebral artery systolic peak flow rate:A negative correlation between hemoglobin concentration and cerebral artery systolic peak flow rate(-0.3 <r <-0.1)was not statistically significant(P> 0.05).Conclusion1.With increasing gestational age at birth,a higher burdjalov score of amplitude-integrated electroencephalogram findings,suggesting a more mature EEG function.2.As the gestational age scales up at birth,the resistance index value of the middle cerebral artery lessens,the peak systolic velocity raises,the end diastolic velocity increases,and the peak systolic velocity / end diastolic velocity ratio decreases,indirectly reflecting the greater maturity of the brain.Peak-systolic flow rate values and end-to-diastolic flow rate values can be used to assess whether cerebrovascular development in term newborns lags behind the gestational age at birth.3.Both amplitude-integrated electroencephalogram and craniocerebral ultrasound are of clinical use when used to evaluate the developmental maturity of preterm brain,and should be popularized in clinical praxis.4.The concentration of potassium ions and sodium ions in the serum can affect the brain electrical function,and may have an effect on protecting the brain tissue.5.No significant correlation was found between the degree of anemia and the peak flow rate of cerebral artery,which needs to be deeper researched after enlarging the sample size.