The value of electroencephalogram combined with serum glial fibrillary acidic protein in the early diagnosis and prognosis evaluation of children with viral encephalitis / 中国医师进修杂志

ABSTRACT

Objective:To explore the values of electroencephalogram (EEG) combined with glial fibrillary acidic protein (GFAP) in the early diagnosis and prognosis evaluation of viral encephalitis (VE).Methods:A total of 63 patients with VE admitted to the Hangzhou Seventh People′s Hospital from January 2016 to December 2019 were selected as the observation group. In addition, 80 healthy people suspected of central nervous system disease in the same period were selected as the control group. The data of gender, age, body mass and body mass index (BMI) were recorded, the Niolet V32 digital EEG instrument of American Nigolli Company was used for EEG inspection, and the level of serum GFAP was detected by enzyme-linked immunosorbent assay (ELISA). The general data, abnormal EEG results and the level of serum GFAP of the control group and the observation group were compared. The diagnostic values of EEG and its combination with serum GFAP in VE were analyzed by four grid table; and the diagnostic value of serum GFAP for VE was evaluated by drawing receiver operating characteristic (ROC) curve.Results:There was no significant difference in sex, age, body mass and BMI between the two groups ( P>0.05). The results of EEG diagnosis for VE showed that 11 of 63 cases were missed and 10 of 80 cases in the control group were misdiagnosed, and the sensitivity, specificity and accuracy of EEG diagnosis for VE were 82.54%, 87.50% and 85.31%, respectively. Compared with that of the control group, the level of serum GFAP of the observation group was higher (460.19 ± 126.53) ng/L vs. (217.36 ± 53.17) ng/L, t =15.525, P<0.05. ROC curve showed that area under curve (AUC) of serum GFAP for VE diagnosis was 0.907 and cutoff value was 238.37 ng/L. The sensitivity, specificity and accuracy of EEG combined with serum GFAP in diagnosing VE were 93.65%, 83.75% and 88.11%, respectively, and the sensitivity and accuracy of EEG combined with serum GFAP were higher than those of EEG and GFAP alone. The results of 12-month follow-up showed that 20 of 63 VE patients had sequel (poor prognosis group), 43 patients had good prognosis (good prognosis group), and the incidence of adverse prognosis was 31.75%(20/63). There were significant differences in EEG and GFAP between the good prognosis group and poor prognosis group ( P<0.05). Conclusions:The sensitivity and accuracy of EEG combined with serum GFAP in the diagnosis of VE are good, which may be used for the early diagnosis and prognosis evaluation of VE.