The application value of aEEG and NBNA in the early evaluation on brain damage for full-term neonates with hyperbilirubinemia

Liting Chen, Yuxiu Guo, Yuan Lyu, Q. Liang, Yanlin Liu, Lingling Zhu
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Abstract

Objective To investigate the application value of amplitude integrated electroencephalogram (aEEG) and neonatal behavioral neurological assessment(NBNA) in the early evaluation on brain damage for full-term neonates with hyperbilirubinemia. Methods From August 2015 to February 2016, 42 full-term neonates with hyperbilirubinemia were divided into two groups:subclinical bilirubin encephalopathy group and hyperbilirubinemia control group according to the results of magnetic resonance imaging(MRI), while 20 normal healthy full-term infants born in our hospital at the same time were chosen as normal control group. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Clinic Medical College of Yangzhou University. Informed consent was obtained from each parents.The serum level of total bilirubin(TB), the score of NBNA, the abnormality rate for brainstem auditory evoked potential (BAEP) and aEEG were compared among three groups,meanwhile the correlation for these parameters were assayed. Results (1)There were significant differences in the level of UCB ,the score of NBNA, the abnormality rate of BAEP and aEEG among different groups (F=20.16, 7.12,χ2=15.18,12.23,P 0.05). (2)Of the 7 mildly abnormal aEEG cases in the subclinical bilirubin encephalopathy group, 6 mildly abnormal and 1 moderately abnormal were found in BAEP test. All of the 9 severely abnormal aEEG cases in the subclinical bilirubin encephalopathy group were found 1 moderately abnormal and 8 severely/very severely abnormal of BAEP. By linear correlation analysis,the abnormality degree of aEEG was positively correlation with BAEP (γ=0.806,P=0.032). (3)22 cases of subclinical bilirubin encephalopathy group inclued 16 abnormal aEEG cases (72.73%) and 21abnormal aEEG with NBNA cases (95.45%) respectively,there were statistically significant differences (χ2=4.08,P<0.05). Conclusion aEEG combining with NBNA may be an reference indicator for early evaluation on brain damage in full-term neonates with hyperbilirubinemia. It has great clinical important value and can be worth popularizing. Key words: aEEG; NBNA; Neonate; Hyperbilirubinemia; Brain damage
aEEG与NBNA在高胆红素血症足月新生儿脑损伤早期评估中的应用价值
目的探讨波幅综合脑电图(aEEG)和新生儿行为神经学评估(NBNA)在足月新生儿高胆红素血症脑损伤早期评估中的应用价值。方法选取2015年8月~ 2016年2月42例高胆红素血症足月新生儿,根据磁共振成像(MRI)结果分为亚临床胆红素脑病组和高胆红素血症对照组,同时选取我院同期出生的正常健康足月婴儿20例作为正常对照组。本研究方案经扬州大学临床医学院人体研究伦理审查委员会批准。获得了每位家长的知情同意。比较三组患者血清总胆红素(TB)水平、NBNA评分、脑干听觉诱发电位(BAEP)和aEEG异常率,并分析这些参数的相关性。结果(1)各组患者UCB水平、NBNA评分、BAEP、aEEG异常率差异均有统计学意义(F=20.16、7.12,χ2=15.18、12.23,P 0.05)。(2)亚临床胆红素脑病组aEEG轻度异常7例,BAEP试验轻度异常6例,中度异常1例。亚临床胆红素脑病组aEEG重度异常9例,BAEP中度异常1例,重度/极重度异常8例。经线性相关分析,aEEG异常程度与BAEP呈正相关(γ=0.806,P=0.032)。(3)亚临床胆红素脑病组22例中,aEEG异常16例(72.73%),aEEG异常伴NBNA 21例(95.45%),差异有统计学意义(χ2=4.08,P<0.05)。结论aEEG联合NBNA可作为早期评价高胆红素血症足月新生儿脑损伤的参考指标。具有重要的临床应用价值,值得推广。关键词:aEEG;NBNA;新生儿;高胆红素血;脑损伤
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