脑电非线性分析频谱熵对意识障碍患者预后评估的作用

摘要

Objective To evaluate the degree of consciousness disorder with electroencephalogram(EEG)non-linear analysis,and to investigate the significance of EEG nonlinear analysis spectral entropy in prognosis evaluation of pa-tients with consciousness disorders. Methods Thirty patients with consciousness disorders( case group)and thirty healthy individuals(control group)were recruited. The data,included EEG,spectral entropy and Glasgow coma score (GCS),were collected. The patients were followed up for 60 days. According to Glasgow outcome scale(GOS),the prognosis of patients was evaluated. Death and VS was defined as poor prognosis,while severe disability,moderate disa-bility and good recovery as good prognosis. Results The nonlinear indexes in case group were significantly lower than those in control group(P < 0. 001). The spectral entropy and GCS in the poor prognosis group were significantly lower than those in good prognosis group(P < 0. 001). The discrimination of spectral entropy in predicting the prognosis of the consciousness disorder was 1. 000( P < 0. 001). The best cut - off point for predicting good prognosis was found as 37. 55. Conclusion Spectral entropy might be an excellent index for degree of consciousness disorder and prognosis eval-uation in the consciousness disorder.%目的：采用脑电非线性分析方法频谱熵评价患者意识障碍程度，探讨脑电非线性分析频谱熵对意识障碍患者预后评估的作用。方法收集30例意识障碍患者（意识障碍组）和30例健康人（对照组），记录其脑电图及频谱熵，同时进行 GCS 评分。随访患者60 d，用格拉斯哥预后评分量表（GOS）评价预后，按 GOS 评分把死亡、植物状态（VS）定义为预后差，把严重残疾、中度残疾、康复良好定义为预后好。结果意识障碍组脑电非线性分析频谱熵明显低于对照组（P <0.001），预后差患者的频谱熵及 GCS 均较预后好患者低（P <0.001）；频谱熵预测意识障碍患者预后的辨别力为1.000（P <0.001），其预测预后好与差的最佳分界点为37.55。结论频谱熵能评估患者意识障碍程度，可作为患者意识障碍程度及预后评估的电生理指标。