脑电图监测在病毒性脑炎诊断及预后的应用价值(1)
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[摘要] 目的 探讨脑电图监测在病毒性脑炎诊断及预后的应用价值。方法 对临床资料完整并经临床确诊的78例病毒性脑炎患者进行24h动态脑电图(AEEG)监测，并与常规脑电图检查(REEG)进行对照。结果 REEG脑电图异常率(51.28%)和痫样放电检出率(25.00%)均明显低于AEEG(89.74%、68.57%)，差异均有统计学意义(P<0.01)。AEEG监测脑电图正常8例未发生后遗症和死亡，脑电图异常程度与预后大致平行；48例痫样放电清醒时出现15例，睡眠中出现33例，差异有统计学意义(P<0.01)。 结论 相比REEG，AEEG监测病毒性脑炎脑电图异常更敏感，预后评估更准确，与临床病情、预后有很高的一致性，对判断疾病严重程度及评估预后有较高的价值。
[关键词] 脑电图监测；病毒性脑炎；诊断；预后
[中图分类号] R512.3[文献标识码] B [文章编号] 1673-9701(2011)27-106-02
Application Value of EEG Monitoring in the Diagnosis and Prognosis of Viral Encephalitis
YANG Yinghong
ECG Laboratory of People's Hospital of Fenghua City in Zhejiang Province，Fenghua 315500，China
[Abstract] Objective To investigate the application value of EEG monitoring in the diagnosis and prognosis of viral encephalitis. Methods All 78 case with viral encephalitis clinically diagnosed and with complete clinical data were taken 24h ambulatory EEG(AEEG) monitoring，and compared with the conventional EEG(REEG) group. Results Abnormality rate of REEG(51.28%) and the detection rate of epileptic discharge(25.00%) were significantly lower than AEEG(89.74%，68.57%)，the differences were statistically significant(P<0.01). AEEG monitoring 8 cases were normal and did not occur sequelae and death，EEG abnormal degree and prognosis were roughly parallel. The epileptic discharge occurred in 15 cases when awake，33 cases occurred during sleep of the 48 patients，the difference was statistically significant (P<0.01). Conclusion Compared with REEG，AEEG on abnormal EEG monitoring in viral encephalitis is more sensitive and more accurate on prognosis，has a high consistency in clinical condition and prognosis and has a higher value.in judging the severity of disease and assess the prognosis.
[Key words] EEG monitoring；Viral encephalitis；Diagnosis；Prognosis
病毒性脑炎是临床常见的中枢神经系统感染性疾病，病毒种类多，临床表现复杂，病情轻重不一，由于目前并无特异性病原学诊断方法，早期鉴别诊断非常困难，尤其以精神异常为首发症状时，易被误诊而延误治疗，导致死亡或神经系统后遗症[1]。尽管脑电图(EEG)并非特异性诊断指标，但其改变早于脑脊液、MRI和头颅CT的变化，对病毒性脑炎的诊断价值已得到大量研究充分验证[2，3]。但关于动态脑电图(AEEG)监测的报道仍然较少。为探讨AEEG监测在病毒性脑炎的早期诊断和预后应用价值，我院对临床资料完整并经临床确诊的78例病毒性脑炎患者进行24h AEEG监测，并与常规脑电图检查(REEG)进行对照。
1资料与方法
1.1一般资料
选取2009年6月～2010年6月收治的病毒性脑炎患者78例，均根据病史、体征、脑脊液、头部CT和/或MRI诊断 ......
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