BAEP及下肢SLSEP检查对急性CO中毒后迟发性脑病的预测价值分析  

The value of brainstem auditory evoked potential and lower limb short latency somatosensory evoked potential for predicting delayed encephalopathy after acute carbon monoxide poisoning

作　　者：李六一[1] 穆俊林[2] 顾仁骏[2] 张宁[2] 杜好瑞[2] 姜文涛[2] 

机构地区：[1]河南省人民医院神经电生理室,郑州450003 [2]新乡医学院第二附属医院

出　　处：《中华物理医学与康复杂志》2010年第5期347-350,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：河南省科技厅资助项目（200624410035）

摘　　要：目的 观察急性CO中毒患者脑干听觉诱发电位（BAEP）及下肢短潜伏期体感诱发电位（SLSEP）的变化,探讨BAEP及下肢SLSEP检查对急性CO中毒后迟发性脑病（DEACMP）的预测价值.方法 共选取66例急性CO中毒患者,并根据患者是否出现DEACMP将其划分DEACMP组及非DEACMP组;同时选取60例健康体检者纳入正常对照组.分别于入选后不同时间点对上述研究对象BAEP及下肢SLSEP进行动态检测,并将其结果进行组间比较.结果 首次检查急性CO中毒患者BAEP及下肢SLSEP的异常率分别为31.8%（21/66）和68.2%（45/66）;急性期及迟发期DEACMP组患者BAEP与非DEACMP组、正常对照组比较,发现除了Ⅰ～Ⅲ波间期组间差异无统计学意义外（P〉0.05）,其余各波潜伏期均显著延长（P〈0.01）;急性期DEACMP组、非DEACMP组下肢SLSEP与正常对照组比较,发现各波潜伏期均显著延长（P〈0.01）;迟发期DEACMP组SLSEP与非DEACMP组及正常对照组比较,发现各波潜伏期均明显延长（P〈0.01）.BAEP检查预测DEACMP的特异度高达85.7%（18/21）,但BAEP诊断DEACMP的阳性率仅为56.3%（18/32）,存在43.7%（14/32）的漏诊率;下肢SLSEP检查预测DEACMP的特异度仅为51.1%（23/45）,明显不及BAEP检查.结论 早期BAEP检查对预测CO中毒后DEACMP发生具有重要价值,值得临床推广、应用.Objective To observe the changes of brainstem auditory evoked potential （BAEP） and lower limb short latency somatosensory evoked potential （ SLSEP） in acute carbon monoxide poisoning patients and explore the predictive value of BAEP and SLSEP for delayed encephalopathy after acute carbon monoxide poisoning （DEACMP）. Methods Sixty-six acute CO poisoning patients was divided into a DEACMP group and a non-DEACMP group according to their symptoms. At the same time, 60 healthy subjects were included in the control group. BAEP and lower limb SLSEP dynamic testing were conducted at different time points. Results The abnormal rates in the first test of BAEP and lower limb SLSEP in the acute CO poisoning patients were 31.8% and 68.2% respectively.The BAEP results in the acute stage and later in the DEACMP group were comparable to those of the non-DEACMP group and the normal control group. Interpeak latency of Ⅰ-Ⅲ was not significantly different, but the remaining indices were significantly longer. Compared to the control group, the lower limb SLSEP readings in the acute DEACMP group and the non-DEACMP group were significantly longer. Compared to the non-DEACMP group and the control group, the SLSEP results of the DEACMP group were significantly extended. The specificity index of the BAEP predicted DEACMP up to 85.7% , significantly more than SLSEP testing. Conclusions Early detection of BAEP can help predict DEACMP. This finding should be promulgated and applied.

关 键 词：脑干听觉诱发电位 下肢体感诱发电位 急性一氧化碳中毒 迟发性脑病 预测 

分 类 号：R747.9[医药卫生—神经病学与精神病学]