瞬目反射对老年人脑干梗死诊断价值的研究  

Diagnostic Value of Blink Reflex: a Study on Patients with Old Peoples Brainstem Infarction

作　　者：赵春雨[1] 田晓彦[1] 张伟兵[1] 张慧[1] 冯岩[2] 

机构地区：[1]哈尔滨医科大学第四临床医学院老年病二病房,黑龙江哈尔滨150001 [2]哈尔滨医科大学第二临床医学院神经外科,黑龙江哈尔滨150086

出　　处：《现代生物医学进展》2013年第22期4263-4266,共4页Progress in Modern Biomedicine

基　　金：黑龙江省卫生厅科研课题(2010-143)

摘　　要：目的:探讨瞬目反射对老年人脑干梗死的诊断价值。方法:采用神经电生理检查方法对100例老年人(50例健康受试者、50例脑干梗死患者)进行BR检测。确定BR正常值,记录各组潜伏期和波幅的变化,与正常对照组比较;并对50例脑干梗死患者行MRI检测,比较MRI与BR对脑干梗死的诊断阳性率。结果:健康对照组BR各波潜伏期的平均值分别是R1为10.9 ms、R2为30.4 ms、R2'为29.5 ms,波幅的平均值分别是R1为306.3μv、R2为276.7μv、R2'为257.8μv。脑干梗死组中有44例BR异常,其中6例中脑梗死患者BR正常;36例桥脑梗死患者BR完全异常;8例延髓梗死患者R1正常,结果具有统计学差异(P<0.01)。BR与MRI检查对脑干梗死的诊断阳性率比较无统计学差异(P>0.05)。结论:瞬目反射是一种早期诊断脑干梗死的有价值的临床电生理方法,相对于传统MRI检查,其诊断率稍低,但能敏感地反应脑干尤其是脑桥的病变情况,对定位诊断有重要意义。Objective： To discuss the diagnostic value of blink reflex（BR） in the old peoples brainstem infarction.Methods： The study was conducted to take the BR examinations to the one handrad old peoples（fifty healthy volunteers,fifty patients of brainstem infarction） with the neural electrophysiological methods.The normal value of BR was established and the changes of the latency and amplitude were record.Then the two groups were compared with t Test.Meanwhile,the study was conducted to take the MRI examinations to the fifty patients of brainstem infarction and the diagnostic positive rate of brainstem infarction of the two methods was compared with X2test.Results： The average latency of the R1,R2 and R2＇ in the control group was respectively 10.9 ms,30.4 ms and 29.5 ms.The average amplitude of the R1,R2 and R2＇ in the control group was respectively 306.3 μv,276.7 μv and 257.8 μv.44 abnormal cases were included into the group of brainstem infarction,whereas the 6 cases of midbrain infarction of BR were normal;the 36 cases of pons infarction of BR were abnormal and R1 were normal in the 8 cases of medulla oblongata infarction.There was significant difference between the two groups（P0.01）.There was not significant difference between the two groups of BR and MRI for the diagnostic positive rate of brainstem infarction（P0.01）.Conclusion： BR is one of the effective clinical electrophysiology methods in the early diagnosis on the brainstem infarction.BR was lower diagnostic rate than MRI,but it could sensitively react the lesions of brainstem especially pons.BR has a significant diagnosis of the lesions of brainstem.

关 键 词：瞬目反射 老年人 脑干梗死 诊断价值 

分 类 号：R741.044[医药卫生—神经病学与精神病学]