摘要： 目的·探讨急性缺血性脑卒中（acute ischemic stroke，AIS）患者早期定量脑电图（quantitative EEG，QEEG）特征和脑CT灌注成像参数的相关性，并分析QEEG特征与美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分的相关性。方法·纳入2014年3月至2016年6月钦州市第一人民医院收治的AIS患者92例，所有患者入院时均急诊给予脑CT灌注成像检查，确定缺血性病变区域，而后给予脑电图监测至少2 h，并于入院后进行NIHSS评分。根据CT灌注图像获得脑血流量（cerebral blood flow，CBF）、平均通过时间（mean transit time，MTT）和峰值时间（time to peak，TTP）等参数。QEEG分析获得α波指数、θ波指数、δ波指数、慢波指数、α/δ相对功率比（ADR）、（δ+θ）/（α+β）相对功率比（DTABR）和脑对称指数（brain symmetry index，BSI）等指标。通过Pearson线性相关性分析，研究缺血性病变区域CT灌注成像参数和QEEG特征之间的相关性，以及CT灌注成像参数、QEEG特征与NIHSS评分的相关性。结果·AIS患者缺血性病变区域与对侧区域相比，CBF减少，MTT和TTP延长，δ波指数、慢波指数和BSI升高，ADR和DTABR降低，差异具有统计学意义（均
P<0.05）。Pearson线性相关性分析显示，MTT与δ波指数、慢波指数、BSI呈正相关（均
P<0.05），与ADR、DTABR呈负相关（均
P<0.05）；TTP与δ波指数、慢波指数、BSI呈正相关（均
P<0.05），与ADR、DTABR呈负相关（均
P<0.05）；NIHSS评分与MTT、TTP、δ波指数、慢波指数、BSI呈正相关（均
P<0.05），与CBF、ADR、DTABR呈负相关（均
P<0.05）。结论·AIS患者的QEEG特征与CT灌注成像参数之间存在相关性。早期记录患者QEEG特征有助于评估缺血灶变化和神经缺损程度，并实现动态监测。
关键词: 急性缺血性脑卒中, 定量脑电图, CT 灌注成像, 相关性 Abstract: Objective·To investigate the correlation between early quantitative electroencephalogram (QEEG) features and brain CT perfusion imaging parameters in the patients with acute ischemic stroke (AIS), and analyze the correlation between QEEG features and National Institutes of Health Stroke Scale (NIHSS) score.
Methods·Ninety-two patients with AIS admitted to the First People's Hospital of Qinzhou from March 2014 to June 2016 were enrolled. All the patients were given emergency CT perfusion imaging to determine the ischemic lesion areas. And then they were monitored by electroencephalogram for at least 2 h. The assessment by using NIHSS was performed after admission. Cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were obtained from CT perfusion imaging. α wave index, θ wave index, δ wave index, slow wave index, α/δ power ratio (ADR), (δ+θ)/(α+β) power ratio and brain symmetry index (BSI) were obtained from QEEG analysis. With Pearson linear correlation analysis, the correlation between CT perfusion imaging parameters and QEEG features in the ischemic lesions, the correlation between CT perfusion imaging parameters and NIHSS score, and the correlation between QEEG features and NIHSS score were analyzed.
Results·The AIS patients had decreased CBF, prolonged MTT and TTP, increased δ wave index, slow wave index and BSI, and decreased ADR and DTABR in the ischemic lesion areas than those in the contralateral regions. The differences were statistically significant (all P<0.05). MTT was positively correlated with δ wave index, slow wave index and BSI (all P<0.05), and negatively correlated with ADR and DTABR (all P<0.05); TTP was positively correlated with δ wave index, slow wave index and BSI (all P<0.05), and negatively correlated with ADR and DTABR (all P<0.05); the NIHSS score was positively correlated with MTT, TTP, δ wave index, slow wave index and BSI (all P<0.05), and negatively correlated with CBF, ADR and DTABR (all P<0.05).
Conclusion·There exists correlation between QEEG features and CT perfusion imaging parameters in the patients with AIS. Early recording of the patients' QEEG features can help assess the changes of ischemic lesions and neurological deficits and realize dynamic monitoring.
Key words: acute ischemic stroke (AIS), quantitative electroencephalogram (QEEG), CT perfusion imaging, correlation PDF全文下载地址:
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