听觉诱发电位对椎基底动脉短暂缺血性眩晕的诊断及疗效评估  

Auditory brainstem response in diagnosis and assessment of theraputic efficacy for patients with vertebrobasilar transient ischemic vertigo

作　　者：李欣[1] 周慧芳[1] 郭英[1] 闫维芹[1] 

机构地区：[1]天津医科大学总医院耳鼻喉科,天津300052

出　　处：《中华耳科学杂志》2007年第2期176-180,共5页Chinese Journal of Otology

摘　　要：目的探讨高刺激率51次∕s听觉诱发电位测试诊断椎基底动脉短暂缺血性眩晕(VBTIV)及进行疗效评估的临床意义。方法正常成年人组50例,排除高血压病、脑动脉硬化等系统疾病,纯音测听、声导抗测试均正常;患者组50例,排除听神经瘤、小脑桥脑角肿瘤等蜗后病变及良性阵发性位置性眩晕。用丹麦Madsen公司2260型脑干诱发电位(ABR)系统测试。给予交替短声刺激,感觉级75dBSL,最大输出为130 dB peSPL。分别给予11、21、51、71次∕s的ABR测试,左、右耳分别检测。患者组在应用凯时治疗两周后,再用同样方法复查ABR。结果采用高刺激率51次∕s ABR与11次∕s ABR的波潜伏期及波间期的差值作为分析参数,患者的各波潜伏期及波间期均较正常人延长,具有统计学意义(P<0.01)。应用高刺激率51次∕sABR测试,在波潜伏期、波间期以及波形异常的检出率上比11次∕sABR高。患者经治疗缓解后其波Ⅲ、Ⅴ潜伏期和Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波间期比发作期明显缩短(P<0.05)。结论与常规低刺激率ABR相比,高刺激率ABR更有助于VBTIV的诊断,还可以监测VBTIV的预后,评价治疗效果,是VBTIV的客观而敏感的辅助诊断方法。Objective To explore the value of the increasing stimulus rate ABR （ISRABR） in diagnosis and theraputic efficacy assessment of vertebrobasilar transient ischemic vertigo （VBTIV）. Methods The control and VBTIV groups cosisted of 50 healthy adults and 50 VBTIV patients, respectively. A 2260 ABR system （Madsen Company, Denmark） was utilized. Alternating clicks were given to the stimulus ear with an intensity level of 75 dB SL and the largest output of 130 dB peSPL. The stimulus rate was 11 / sec, 21 /sec, 51 / sec and 71 / sec. Records were obtained from both ears. In the VBTIV group, after the patients were treated with prostaglandin E for two weeks, their syndromes were improved and the ABR was examined with the same method again. Results If the difference between 51/sec ABR and 11/sec ABR was taken as the criteria, the ABR wave latencies and interpeak latencies in patients were prolonged than those in healthy adults （P〈0.01）. After the patients were treated for two weeks, the ABR wave latencies and interpeak latencies were shortened than that before therapy （P〈 0.05）. Conclusion ABR with high stimulus rates can be useful in making the diagnosis of VBTIV.

关 键 词：听觉诱发电位 椎基底动脉短暂性缺血 眩晕 前列地尔(凯时) 疗效评估 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R743.31[医药卫生—临床医学]