59例听神经瘤患者脑干听觉诱发电位分析  

Analysis of brainstem auditory evoked potential in 59 patients with acoustic neuroma

作　　者：殷晓梅[1,2] 喻廉[1,2] 赵燕[1,2] 黄天虹[1,2] 徐惠金[1,2] 徐莉[1,2] 

机构地区：[1]安徽省立医院 [2]安徽省立体定向神经外科研究所,合肥230001

出　　处：《立体定向和功能性神经外科杂志》2007年第3期157-161,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的分析听神经瘤(acoustic neuroma,AN)患者的脑干听觉诱发电位的变化特征及健侧耳峰间期改变。方法对59例听神经瘤(AN)患者进行脑干听觉诱发电位(BAEP)检测,测定Ⅰ、Ⅲ、Ⅴ波潜伏期(PL)、峰间期(IPL),双耳PL、IPL之间差值(ILD)等数值。结合MRI、CT影象学资料进行分析,并与36例健康者对照。结果AN组与正常对照组BAEP各波PL、IPL测值比较差异有极显著性(P<0.01)。AN患侧BAEP异常率98.3%(58/59);主要表现:①Ⅰ、Ⅲ、Ⅴ波缺失;②Ⅲ、Ⅴ波PL延长;③Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长。AN患者健侧BAEP的异常率69.5%(41/59),主要表现:①Ⅴ波PL延长;②Ⅲ～Ⅴ及Ⅰ～Ⅴ波IPL延长;③Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值>1。肿瘤直径>2cm,BAEP的异常率有显著提高。不同大小肿瘤组间健侧BAEP测值比较:健侧Ⅴ波PL差异有显著性(P<0.05),Ⅲ～Ⅴ及Ⅰ～ⅤIPL差异有极显著性(P<0.01)。结论BAEP对AN诊断具有重要意义,它为病变提供了定位诊断依据,尤其健侧Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值异常,是脑干受压的敏感指标。Objective To analysia of the changes and characteristics of the interpeak latency of normal side of brainstem suditory evoked potential （BAEP） of patients with acoustic neuroma （AN）. Methods BAEP of 59 AN patients and 36 controls were determined, and the peak latency （PL） of Ⅰ,Ⅲ,Ⅴ wave,and the interpeak latency （IPL） of Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ wave ,and interlateral latency difference（ILD） of the PL and IPL were determined, combine the MRI/CT image of the patients, compared with controls. Results The PL and IPL of in ears with AN was significantly prolongation then controls（P〈0.01）. The abnormal rate of BAEP in ears with AN was 98.3%（58/59） ; mainly showing ：①Disappearance of Ⅰ,Ⅲ,Ⅴ;②Prolongation of PL of Ⅲ,Ⅴ wave ;③Prolongation of IPL of Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ wave. The abnormal rate of BAEP in contralateral was 69.5 % （41/59）, mainly showing ： ①Prolongation of PL of V wave ;②Prolongation of IPL of Ⅲ-Ⅴ ,Ⅰ-Ⅴ wave;③The rate of IPL of Ⅲ-Ⅴ to IPL of Ⅰ-Ⅲ wave were hyper-1. The abnormal rate of BAEP in patients with tumors diameter more then 2cm were significantly increase. The data of contralateral in difference tumors diameter showing ：The PL of Ⅴ wave ,and IPL of Ⅲ -Ⅴ , Ⅰ-Ⅴ wave was significantly prolongation. Conclusion To determined BAEP has important value in diagnosis AN,It＇s the gist for locked the pathological changes, especially the abnormal rate of IPL of Ⅲ-Ⅴ to IPL of Ⅰ-Ⅲ wave of contralateral in AN, it＇s sensitive indicator to damage of brainstem.

关 键 词：听神经瘤 脑干听觉诱发电位 潜伏期 峰间期 

分 类 号：R739.41[医药卫生—肿瘤]