亚急性联合变性的神经电生理研究  

Electroneurophysiology research of subacute combined degeneration

作　　者：曾文双[1] 童晓欣[2] 苏曼[2] 

机构地区：[1]香港大学深圳医院神经内科,广东深圳518000 [2]北京大学深圳医院神经内科

出　　处：《癫痫与神经电生理学杂志》2016年第1期12-14,共3页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨神经电生理检查在亚急性联合变性（SCD）早期诊断及疾病预后判定中的意义。方法：选取35例SCD患者，分别进行脊髓MRI、胫后神经体感诱发电位（SEP）、正中神经SEP、视觉诱发电位（VEP）和神经传导速度（NCV）检查，比较上述检查阳性率的差异，探讨不同检查的诊断敏感性及其对应神经结构受累的时序差别。结果：本组30例SCD患者接受脊髓MRI检查，其中有12例（40％）发现异常，35例接受胫后神经SEP、正中神经SEP、VEP、NCV检查，分别有32例（91％）、23例（66％）、7例（20％）和15例（43％）发现异常。PT-SEP与脊髓MRI的阳性率存在显著差异（P〈0．05），PT—SEP、MN—SEP、VEP、NCV的阳性率也存在显著差异（P〈O．05）。结论：①神经电生理检查在SCD的诊断过程中具有较高的敏感性，对SCD的早期诊断具有重要的临床意义；②神经电生理检查可以反映sCD神经结构受累的范围及时序，对SCD的疾病预后判定有一定帮助。Objective： To explore the significance of electroneurophysiology test in early diagnosis and prognosis assessment of subacute comdined degeneration（SCD）. Methods： 35 patients with SCD were selected to receire spinal MRI, PT-SEP, MN-SEP, VEP and NCV respectively, and the positive rates from the tests were compared, and the difference of diagnostic sensibility and timing sequence of relevant nerve structure damages were observed. Results：Of 30 patients in the experiment who accepted spinal MRI, 12 had abnormal symtoms ; Of 35 patients who accepted PT-SEP, MN-SEP, VEP and NCV, 32,23,7,15 had abnormal symtoms respectively. There existed significant difference of positive rate between spinal MRI and PT-SEP（32/35vs12/30,P〈0. 05）,and between PT-SEP, MN-SEP,VEP andNCV（32/35 vs23/ 35vsT/35vs 15/35, P〈0. 05）. Conclusion： （1）Electroneurophysiology tests have higher sensibility than other tests in diagnosis of SCD,with the important clinical significance in early diagnosis;（2）Electroneurophysiology test can reflect the territory and timing sequence of nerve structure damage of SCD. It is helpfal for the prognosis assessment of SCD.

关 键 词：亚急性联合变性(SCD) 体感诱发电位(SEP) 视觉诱发电位(VEP) 神经传导速度 (NCV) 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R744.6[医药卫生—临床医学]