振幅整合脑电图评估孕妇产前糖皮质激素治疗对早产儿脑发育的影响

Effects of antenatal corticosteroid therapy in pregnant women on the brain development of preterm infants as assessed by amplitude-integrated electroencephalography

摘要:

目的 通过振幅整合脑电图（amplitude-integrated electroencephalography, aEEG）探讨孕妇产前糖皮质激素（antenatal corticosteroid, ACS）治疗对早产儿脑发育的影响。方法 回顾性纳入胎龄28⁺⁰~34⁺⁶周早产儿211例，根据产前是否使用地塞米松进行促胎肺成熟治疗分为ACS组（131例）和对照组（80例）。在生后24 h内进行首次aEEG监测（记为aEEG1），生后5~7 d进行第2次aEEG监测（记为aEEG2），对aEEG结果进行分析比较。结果 胎龄28⁺⁰~31⁺⁶周早产儿中，ACS组相较于对照组，aEEG1周期性更成熟、振幅下边界更高（P<0.05）；胎龄32⁺⁰~33⁺⁶周及胎龄34⁺⁰~34⁺⁶周早产儿中，ACS组相较于对照组，连续模式比例更高、周期性更成熟且Burdjalov评分更高（P<0.05）。胎龄32⁺⁰~33⁺⁶周及胎龄34⁺⁰~34⁺⁶周早产儿中，ACS组相较于对照组，aEEG2连续模式比例更高、周期性更成熟、振幅下边界更高、波谱带宽更窄且Burdjalov评分更高（P<0.05）。结论 ACS治疗早产儿比未行ACS早产儿aEEG图形更成熟，ACS对早产儿脑发育有一定促进作用。

Abstract:

Objective To investigate the effects of antenatal corticosteroid (ACS) therapy in pregnant women on the brain development of preterm infants using amplitude-integrated electroencephalography (aEEG).Methods A retrospective analysis was conducted on 211 preterm infants with a gestational age of 28 to 34⁺⁶ weeks. The infants were divided into an ACS group (131 cases) and a control group (80 cases) based on whether antenatal dexamethasone was given for promoting fetal lung maturity. The first aEEG monitoring (referred to as aEEG1) was performed within 24 hours after birth, and the second aEEG monitoring (referred to as aEEG2) was performed between 5 to 7 days after birth. The aEEG results were compared between the two groups.Results In preterm infants with a gestational age of 28 to 31⁺⁶ weeks, the ACS group showed a more mature periodic pattern and higher lower amplitude boundary in aEEG1 compared to the control group (P<0.05). In preterm infants with a gestational age of 32 to 33⁺⁶ weeks and 34 to 34⁺⁶ weeks, the ACS group showed a higher proportion of continuous patterns, more mature periodic patterns and higher Burdjalov scores in aEEG1 (P<0.05). And the ACS group exhibited a higher proportion of continuous patterns, more mature periodic patterns, higher lower amplitude boundaries, narrower bandwidths, and higher Burdjalov scores in aEEG2 (P<0.05).Conclusions ACS-treated preterm infants have more mature aEEG patterns compared to those not treated with ACS, suggesting a beneficial effect of ACS on the brain development of preterm infants.