上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

成人急性脑损伤脑电双频指数和格拉斯哥昏迷评分相关性研究

书国伟，张 珏，费智敏，陈 丽，蔡佩浩，王静予，邱 峰，孔令军，许乐宜，龚 立   

  1. 上海中医药大学附属曙光医院神经外科， 上海 201203
  • 出版日期:2013-07-28 发布日期:2013-08-22
  • 通讯作者: 费智敏, 电子信箱: feizhimin@126.com。
  • 作者简介:书国伟（1973—），男，主治医师，硕士; 电子信箱: sgwcm20030627@163.com。

Correlative study of bispectral index and Glasgow coma scale in adults with acute brain injury

SHU Guo-wei, ZHANG Jue, FEI Zhi-min, Chen Li, CAI Pei-hao, WANG Jing-yu, QIU Feng, KONG Ling-jun, XU Le-yi, GONG Li   

  1. Department of Neurosurgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
  • Online:2013-07-28 Published:2013-08-22

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摘要：

目的 研究成人急性脑损伤患者格拉斯哥昏迷评分（GCS）与脑电双频指数（BIS）值的相关性，探讨BIS值评估脑损伤程度的可行性。方法 采用前瞻、双盲法，收集89例成人急性脑损伤患者GCS和BIS值，计算不同程度脑损伤患者的BIS平均值，对BIS与GCS值行一元线性回归，分别绘制诊断GCS<9和诊断GCS<13的受试者工作（ROC）曲线。结果 轻、中、重度脑损伤组患者的BIS值分别为81.29±7.29、69.32±8.50、45.79±12.39，组间比较差异均有统计学意义（P<0.01）。BIS值与GCS值呈线性正相关（R2=0.825，P<0.01），回归方程BIS=4.23×GCS+22.22。诊断GCS<9的ROC曲线：曲线下面积（AUC）=0.963，截断点BIS=63.8时，敏感度+特异度最大（敏感度=0.932，特异度=0.933）；诊断GCS<13的ROC曲线：AUC=0.933，截断点BIS=71.6时，敏感度+特异度最大（敏感度=0.905，特异度=0.851）。结论 急性脑损伤患者的BIS值与GCS值呈显著正相关，作为一种连续、实时、客观的方法，BIS可成为新型的脑损伤程度评估和监测工具。

关键词: 急性脑损伤, 格拉斯哥昏迷评分, 脑电双频指数, 相关性

Abstract:

Objective To investigate the correlation between Glasgow coma scale (GCS) and bispectral index (BIS) in adults with acute brain injury, and explore the feasibility of BIS value in assessment of brain injury. Methods The prospective and double-blinded design was adopted, and the GCS and BIS values of 89 adults were collected. The mean BIS values of patients with different severity of brain injury were calculated. Linear regression between BIS value and GCS value was constructed, and receiver operating characteristic (ROC) curves at GCS <9 or <13 were plotted respectively. Results There were significant differences in BIS values among patients with mild, moderate and severe brain injury (81.29±7.29, 69.32±8.50 and 45.79±12.39 respectively, P<0.01). There was a significantly
positive correlation between GCS value and BIS value (R2=0.825, P<0.01). The regression equation was BIS=4.23×GCS+22.22. The ROC curve at GCS<9
demonstrated that the area under the curve (AUC) was 0.963, and the cut-off point (BIS value) corresponding with the maximum sensitivity (0.932) and
specificity (0.933) was 63.8.The ROC curve at GCS score<13 demonstrated that AUC was 0.933, and the cut-off point (BIS value) corresponding with the
maximum sensitivity (0.905) and specificity (0.851) was 71.6. Conclusion BIS value significantly correlates with GCS value in adults with acute brain
injury. As a continuous, real-time and objective parameter, BIS can be used as a new tool to assess and monitor the severity of brain injury.

Key words: acute brain injury, Glasgow coma scale, bispectral index, correlation