阻塞性睡眠呼吸暂停低通气综合征导致脑干损伤的颈性前庭诱发肌源性电位评估  

Cervical vestibular evoked myogenic potential assessment of brain steminjury caused by obstructive sleep apnea hypopnea syndrome

作　　者：岑瑞祥[1] 赵凯 万浪[1] 龚国清 曹炜[1] 刘原宙 CEN Ruixiang;ZHAO Kai;WAN Lang;GONG Guoqzng;CAO Wei;LIU Yuanzhou(Department of Otolaryngology Head and Neck Surgery, Huangshi Central Hospital of Edong Healthcare Group, Huangshi,Hubei,435000,China)

机构地区：[1]鄂东医疗集团黄石市中心医院耳鼻咽喉头颈外科,湖北黄石435000

出　　处：《中国耳鼻咽喉头颈外科》2018年第12期683-686,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的通过颈性前庭诱发肌源性电位(cV EM P)评估阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者氧化应激、局部缺血、周期性缺氧引起的脑干损伤情况。方法搜集了2015年11月～2018年3月收治的33例OSAHS患者,中度8例,重度25例,双侧均行c VEMP测试的临床资料;以33例健康成年人作对照组。比较OSAHS组、对照组c VEMP的引出率、潜伏期和振幅的差异。结果 (1)组内比较:OSAHS组的左右侧、对照组左右侧c VEMP的引出率、潜伏期、振幅进行比较,差异均无统计学意义(P>0.05)。(2)组间比较:OSAHS组与对照组的c VEMP的引出率分别66.67%、100.00%,差异具有统计学意义(P<0.05),其中重度OSAHS的c VEMP引出率为64.00%。OSAHS组、对照组c VEMP的P1潜伏期分别为(14.145±1.934)ms、(13.982±2.047)ms,差异无统计学意义(P>0.05)。OSAHS组与对照组c VEMP的N1潜伏期分别为(24.032±2.081)ms、(23.732±2.125)ms,差异无统计学意义(P>0.05)。OSAHS组、对照组c VEMP的P1-N1的振幅分别为(37.893±20.776)μV、(76.882±16.956)μV,差异具有统计学意义(P<0.05),其中重度OSHAS患者的P1-N1振幅显著减小。结论中度和重度OSAHS患者的c VEMP的引出率、P1-N1振幅均下降,提示其脑干的神经传导通路出现异常。c VEMP作为一种无创的检查手段因而也可以用于检测因OSAHS引起的脑干损伤。OBJECTIVE Cervical vestibular evoked myogenic potential(cVEMP)was used to assess cerebral injury caused by oxidative stress,ischemia,and periodic hypoxia in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS Thirty-three patients with OSAHS admitted from November 2015 to March 2018 were enrolled.Eight patients were moderate and 25 patients were severe.The clinical data of cVEMP were performed on both sides.33 healthy adults were used as control group.The differences in the extraction rate,latency and amplitude of cVEMP in the OSAHS group and the control group were compared.RESULTS 1.Comparison within the group:The extraction rate,latency and amplitude of cVEMP in the left and right sides of the OSAHS group and the left and right sides of the control group were compared, and the difference was not statistically significant(P>0.05). 2.The extraction rates of cVEMP in OSAHS group and control group were 66.67% and 100.00%,respectively,and the difference was statistically significant(P<0.05).The cVEMP extraction rate of severe OSAHS was 64.00%.The P1 latency of cVEMP in OSAHS group and control group was (14.145±1.934)ms and (13.982±2.047)ms,respectively, and the difference was not statistically significant(P>0.05). The N1 latency of cVEMP in OSAHS group and control group were (24.032±2.081)ms and (23.732±2.125)ms, respectively,and the difference was not statistically significant(P>0.05).The amplitudes of P1-N1 in the OSAHS group and the control group were (37.893±20.776)μV and (76.882±16.956)μV,respectively,and the difference was statistically significant(P<0.05).The P1-N1 amplitude of patients with severe OSHAS was significantly reduced. CONCLUSION The extraction rate and P1-N1 amplitude of cVEMP were decreased in patients with moderate and severe OSAHS,suggesting abnormalities in the nerve conduction pathway of the brainstem,cVEMP can also be used as a non-invasive test to detect brain stem damage caused by OSAHS.

关 键 词：睡眠呼吸暂停 阻塞性 前庭诱发肌源性电位 反应时间 脑干 

分 类 号：R766[医药卫生—耳鼻咽喉科]