瞬目反射对早期面神经炎的诊断及预后评估应用  

The diagnosis and prognostic evaluation of blink reflex in early facial neuritis

作　　者：冉亚娟 邱志茹[1] 王少平[2] 张怲谦 

机构地区：[1]郑州市第一人民医院,郑州450004 [2]郑州大学第一附属医院,郑州450052

出　　处：《中国实用神经疾病杂志》2014年第5期6-8,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨瞬目反射(blink reflex,BR)对早期面神经炎的诊断及预后评估作用。方法对95例早期(发病7d内)诊断为面神经炎患者行BR、面神经传导检查,根据BR异常类型分组,随访患者预后情况。结果 (1)95例均出现BR的传出型异常,异常率100%;BR异常分为完全传导阻滞和不全传出型异常,本文分别为56例、39例,前者表现为患侧无反应,即无R1、R2及健侧cR2,后者表现为患侧R1缺如或波幅降低伴潜伏时延长,患侧R2及健侧cR2波幅降低伴潜伏时延长;面神经传导检查异常10例,异常率10.53%。(2)随访2组患者预后,行Kaplan-Meier法生存分析,差异有统计学意义(P<0.001)。结论在早期面神经炎的诊断中,BR具有较高的灵敏度,异常率明显高于面神经传导;BR完全传导阻滞组恢复时间长于不全传出异常组,根据BR异常类型可对早期面神经炎的预后进行初步评估。Objective To investigate the value of diagnosis and prognostic evaluation of blink reflex（BR） in early facial neuritis. Methods A total of 95 patients with facial neuritis were undergone with blink reflex and facial nerve conduction stud- ies （NCS） within seven days after symptom onset. The cases were divided into two groups according to the abnormal type of BR. The patients＇ prognostic time was also followed up. Results ① Efferent anomalies of BR occurred among All the 95 pa- tients and the abnormal rate was 100 %. Two types of efferent anomalies were complete efferent retardarce （n= 56）and incom- plete efferent anomalies（n= 39） respectively. The former showed absent response of ipsilateral R1, R2 and the healthy sides＇ contralateral R2 response（cR2）. The latter showed ipsilateral R1 absence or its amplitude reduced , combining with its latencies prolonged, and the amplitude of R2,cR2 reduced or/and their latencies prolonged. There were only 10 abnormal results of pa- tients＇ NCS, and the abnormal rate was 10. 530%. ②There was significant difference between the two groups patients＇ prog- nostic time solved with Kaplan-Meier survival analysis test（P〈0. 001）. Conclusion There is a high sensitivity of BR in the ear- ly diagnosis of facial neuritis. The abnormal rate of BR is higher than that of facial NCS. The prognostic time of patients with complete efferent retard is longer than that of those with incomplete efferent anomaly. Prognosis of patients with early facial neuritis can be evaluated according to the abnormal type of BR.

关 键 词：瞬目反射(BR) 面神经炎 神经传导 

分 类 号：R745.12[医药卫生—神经病学与精神病学]