单模式与多模式诱发电位对重症脑血管病患者的预后评估  

Prognostic evaluation of single modal and multimodal evoked potentials in patients with severe cerebrovascular disease

作　　者：庞英[1] 宿英英[1] 

机构地区：[1]首都医科大学宣武医院神经内科重症监护病房,北京100053

出　　处：《中国脑血管病杂志》2006年第11期501-503,516,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：北京市科委科研基金资助项目(953304003)

摘　　要：目的探讨单模式与多模式诱发电位对重症脑血管病患者脑损伤程度的评价和预测预后的准确性。方法对42例急性中、重度(格拉斯哥昏迷评分≤12分)幕上脑血管病患者进行短潜伏期体感诱发电位(SLSEP)和听觉诱发电位(BAEP)监测,根据病后3个月的格拉斯哥预后评分分为预后良好组(8例)与预后不良组(34例),依据单模式诱发电位分级标准(Judson、Hall标准)和多模式诱发电位分级标准(Cant标准)进行分级,并进行单模式与多模式之间特异性和准确性的比较。结果单模式和多模式各分级标准与预后均有显著相关性,级别越高,预后越差。单模式SLSEP预测特异性、准确性(分别为97.1%和92.9%)高于BAEP(94.1%和90.5%)。多模式诱发电位预测准确性与单模式体感诱发电位相同。结论单模式体感诱发电位能较准确地预测幕上重症脑血管病患者的预后。Objective To compare the evaluation of the degree of brain damage and prognostic accuracy with single modal and muhimodal evoked potentials in patients with severe cerebrovascular disease. Methods Forty-two patients with acute moderate to severe supratentorial cerebral vascular disease （Glasgow Coma Scale [GCS] scores ≤12） were monitored with short latency somatosensory evoked potential （SLSEP） and brainstem auditory evoked potential （BAEP）, depending upon Glasgow Outcome Scale （GOS） , they were divided into favorable group （n = 8 ） and unfavorable group （n = 34） within 3 month after the onset according to the standards of single modal （Judson and Hall＇s standard） and muhimodal （Cant＇s standard） evoked potentials. The specific and accurate comparisons between single modal and muhimodal evoked potentials were undertaken. Results There were significant correlations between the single modal, muhimodal grading standards and prognosis, the higher the grade, the poorer the prognosis was. The specificity and accuracy of single modal SLSEP （97. 1% and 92. 9%, respectively） were higher than those of BAEP （94. 1% and 90. 5% , respectively）. The accuracy of multimodal evoked potentials was the same as that of the single modal SLSEP. Conclusion Single modal SLSEP may more accurately predict the prognosis of severe supratentorial cerebrovascular disease.

关 键 词：诱发电位 脑血管疾病 分级标准 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]