Prognosis Evaluated with Cerebral Electrical Activity in Neonates with Hyperbilirubinemia / 实用儿科临床杂志

ABSTRACT

Objective To investigate the correlation between the plasma unconjugated bilirubin(UCB)and electrical activity of brain in term neonates with hyperbilirubinemia,and explore the parameters that possess the prognostic value and deduce a series of discriminant for prognostic judgment.Methods Thirty-two neonates with hyperbilirubinemia and 31 neonates without hyperbilirubinema(control group)were studied with standard EEG,and they were assessed for their neurological development in 3 and 6 months.A statistical method of Bayes Discriminant analysis was adopted to set up an equation with values of parameters of EEG,clinic datum and consequence.Stepdic and Dis-grim processes were used to pick out the parameters which had great significance for predicting the outcome of nervous system development.A series of discriminant was deduced for prognostic judgment and then cross validation was performed to assess the accuracy of the discriminant.Results 1.The standard EEG and brain electrical activity map records indicated that the hyperbilirubinemia group had longer maximum duration of interburst interval(IBI),longer mean duration of IBI,lower amplitude under all conditions,more anterior dysrhythmia(AD)in wake,and higher incidence of sleep-wake cycle disturbance.2.The plasma concentration of UCB was linear correlated with AD in wake.3.Gestational age,birth weight,plasma concentration of UCB,burst duration of IBI in trace alternate,amplitude in all sleep state,AD in wake,brief burst not in quiet sleep and sleep-wake cycle disturbance might play important roles in predicting the outcome of neonates with hyperbilirubinemia.Conclusions Cerebral electrical activity is an effective tool for predicting neurologic outcome of neonates with hyperbi-lirubinemia.Cerebral electrical activity and clinic data will provide a new method for accurately predicting neurological development and prognosis.