Prolonged EEG depression in term and near-term infants with hypoxic ischemic encephalopathy and later development of West syndrome
Prolonged EEG depression in term and near-term infants with hypoxic ischemic encephalopathy and later development of West syndrome
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DOI：
10.1111/j.1528-1167.2010.02727.x
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发表时间：
2010-12-01
期刊：
影响因子：
5.6
通讯作者：
Watanabe, Kazuyoshi
中科院分区：
文献类型：
--
作者：
Kato, Toru;Okumura, Akihisa;Watanabe, Kazuyoshi
目的：本研究旨在阐明足月及近期新生儿缺氧缺血性脑病（HIE）脑电图（EEG）持续下降与后期发展为West综合征（WS）的关系。方法：对17例足月及近期HIE患儿进行调查。纳入标准为：>= 35孕周，HIE临床体征，HIE对应的MRI病变，> - 18月龄预后评估，脑电图抑郁，脑电图系列检查。将17例婴儿分为两组：A组（n = 4）在21日龄时出现脑电图抑制延长，B组（n = 13）在21日龄时脑电图抑制消失。结果：A组4例婴儿均发生WS， b组13例婴儿中仅有1例发生WS， A组WS发生率明显高于b组。对于WS后续发展的预测，21日龄延长脑电图抑制的敏感性为0.80，特异性为1.0。在两组中，11名2至28日龄的婴儿出现了伴有或不伴有脑电图抑制的异常不规则快波。它们与WS无显著关系，但与不良发育结局显著相关。结论：足月或近期HIE患儿21天以上脑电图持续下降是WS后期发展的重要预测指标。
P>Purpose:This study was performed to clarify the relationship between prolonged depression of electroencephalography (EEG) in term and near-term infants with hypoxic ischemic encephalopathy (HIE) and the later development of West syndrome (WS).Methods:We investigated 17 term and near-term infants with HIE. Inclusion criteria were as follows: >= 35 weeks of gestation, clinical signs of HIE, magnetic resonance imaging (MRI) lesions corresponding to HIE, assessment of outcome at > 18 months of age, depression of EEG, and serial EEG examinations. The 17 infants were divided into the following two groups: Group A (n = 4) with prolonged EEG depression over 21 days of age, and group B (n = 13) with disappearance of EEG depression by 21 days of age.Results:WS developed in all four infants in group A, but in only one of 13 infants in group B. WS occurred significantly more frequently in group A than in group B. For the prediction of subsequent development of WS, prolonged EEG depression over 21 days of age showed sensitivity of 0.80 and specificity of 1.0. In both groups, abnormal irregular faster waves with or without EEG depression were seen in 11 infants between 2 and 28 days of age. They had no significant relationship with WS, but were significantly related to an adverse developmental outcome.Conclusions:Prolonged depression of EEG over 21 days of age in term or near-term infants with HIE is a valuable predictor of the later development of WS.