下肢短潜伏期体感诱发电位对大面积脑梗死患者早期死亡预测价值  

Value of lower-limb short latency somatosensory evoked potentials in predicting early death in patients with massive cerebral infarction

作　　者：郑伟城[1] 潘速跃[1] 林正豪[1] 吴永明[1] 姬仲[1] 刘丽芳[1] 

机构地区：[1]南方医科大学南方医院神经内科,广东广州510515

出　　处：《南方医科大学学报》2009年第5期1036-1039,共4页Journal of Southern Medical University

摘　　要：目的探讨下肢短潜伏期诱发电位对大面积脑梗死患者早期死亡预测的价值。方法分别对南方医院神经内科重症监护病房(NICU)2008年3月至2009年3月收治的48例大面积脑梗死患者进行下肢短潜伏期体感诱发电位(SLSEP)检查和格拉斯哥-匹斯堡评分(GPCS),并对两者进行分级,以改善转出NICU或恶化死亡为时间点,将患者预后分为生存和死亡(包括脑死亡)两组,比较两指标分级水平与预后的相关性。结果SLSEP与大面积脑梗死早期预后有显著相关性,相关系数r=0.484,P<0.001,预测准确率73%,SLSEP3级对死亡的阳性预测值为100%,恶性大脑中动脉卒中(mMCAI)患者SLSEP3级者死亡率100%。结论SLSEP3级对大面积脑梗死早期死亡判断有较高特异性,并对早期判断mMCAI外科治疗时机有参考价值。Objective To explore the value of lower-limb short latency somatosensory evoked potentials （SLSEP） in predicting early death in patients with massive cerebral infarction. Methods Forty-eight patients of massive cerebral infarction were admitted in the Neurological Intensive Care Unit （NICU） between March 2008 and March 2009, and Glasgow-Pittsburgh coma scale （GPCS） and SLSEP were recorded and graded within 24 h after admission. The patients were divided into survival and death groups （including brain death） according to their short-term prognosis. The correlations of SLSEP and GPCS to the mortality were assessed. Results A significant correlation was found between SLSEP and the mortality in patients with massive cerebral infarction （r=0.484, P〈0.001）. The positive predictive value of the SLSEP grade 3 to death was 100%, and the patients with malignant middle cerebral artery infarction （mMCAI） appeared to have a 100% mortality. Conclusion SLSEP grade 3 can be a highly specificity in predicting early death in patients with massive cerebral infarction, and it is also of value in determining the timing of surgical intervention of mMCAI.

关 键 词：体感诱发电位 格拉斯哥-匹斯堡评分 死亡预测 阳性预测值 阴性预测值 灵敏度 特异度 准确率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]