脑干听觉诱发电位和ESRS结合对椎动脉型颈椎病的诊断价值探讨  

Diagnostic value of BAEP associated ESRS for cervical spondylosis of vertebral artery type(CSA)

作　　者：王乐平[1] 高峰[1] 陈金关[2] 

机构地区：[1]浙江省嘉兴市中医医院神经内科,浙江嘉兴314000 [2]中山医科大学附属第二医院老年科,广东广州510080

出　　处：《中国现代医生》2014年第6期25-27,共3页China Modern Doctor

基　　金：浙江省中医基层适宜技术培育和推广研究计划(2011ZS005);浙江省嘉兴市科技计划项目(2011AY1051-3)

摘　　要：目的 探讨脑干听觉诱发电位（BAEP）联合Essen卒中风险量表（ESRS）对椎动脉型颈椎病（CSA）的诊断价值.方法对本院神经内科住院诊治的71例CSA患者,依其旋颈试验是否引起明显的视物旋转分为试验组（n=27）和对照组（n=34）,入院时和治疗2周后行脑干听觉诱发电位检查,并比较两组BAEP、Essen卒中风险量表评分及HSCP IL-6、NSE水平变化.结果试验组Ⅰ～Ⅲ和或Ⅲ～Ⅴ波IPL异常率高于对照组,试验组Ⅰ～Ⅲ和/或Ⅲ～Ⅴ波的IPL好转率高于对照组,试验组Essen卒中风险量表评分的高危率高于对照组,其差异有统计学意义,而两组的HSCP IL-6、NSE水平差异无统计学意义.结论将BAEP的Ⅰ～Ⅲ和或Ⅲ～Ⅴ波的峰间值异常率、好转率及ESRS的高危率结合起来可作为以视物旋转为主而无明显脑干症状和体征也无相关梗死灶的CSA的后循环缺血（PCI）诊断的直接客观依据,对临床治疗及预后具有一定的意义.Objective To study the diagnostic value of cervical spondylosis of vertebral artery type （CSA） by BAEP as- sociated ESRS. Methods Seventy-one patients with CSA at department of neurology was distributed into two groups according to obvious vertigo by the test of revolved cervical vertebra：test＇s group （n=27） and contrast＇s group（n=34）,then compared with the change of BAEP ESRS and the numerical level of HSCP IL-6 or NSE. Results Unusual rate of IPL with I -III and or III-V in test＇s group, It was higher than the contrast＇s group. Improving rate of IPL with I- III and or III-V in test＇s group, It was higher than the contrast＇s group too.High dangerous rate of ESRS more than contrast＇s group.The difference was statistically significant.But the numerical level of HSCP IL-6 or NSE, It was no more than contrast＇s group, and it wasn＇t statistically significant. Conclusion It is regarded as CSA directive objective diagnostics evidence, It is regarded the direct and objective evidence about the PCI, symptom of CSA. It united with unusual rate Improving rate and High dangerous rate. The CSA with maior vertigo is non obvious symptom of brain stem and non related infarction.It may be significant to the treatment and prevision.

关 键 词：脑干听觉诱发电位 Essen卒中风险量表 椎动脉型颈椎病 后循环缺血 诊断 

分 类 号：R681.5[医药卫生—骨科学]