多焦视觉诱发电位在脑性瘫痪患儿中的应用  

The Application of Multifocal Visual Evoked Potentials in Cerebral Palsy Children

作　　者：唐昂藏[1] 罗蓉[2] 董晓丽[3] 刘陇黔[1] 

机构地区：[1]四川大学华西医院眼科,成都610041 [2]四川大学华西第二医院儿童神经康复科 [3]成都市中西医结合医院儿童康复科

出　　处：《华西医学》2016年第6期1074-1079,共6页West China Medical Journal

摘　　要：目的 观察比较脑性瘫痪（脑瘫）患儿与正常儿童多焦视觉诱发电位（mf VEP）振幅与潜伏期的变化。方法 脑瘫组为四川大学华西第二医院儿童神经康复科及成都市中西医结合医院儿童康复科2009年-2013年收治的脑瘫（单肢瘫痪）儿童14例（年龄4~7岁）。对照组为同一时期就诊于四川大学华西医院眼科的正常儿童14例（年龄5~9岁）。所有受试者的双眼均进行mf VEP检查,mf VEP检查结果中的振幅与潜伏期用于数据分析。首先分析14例脑瘫患儿与对照组之间的波形（潜伏期、振幅）差异;应用粗大运动功能分级系统（GMFCS）分级标准对14例脑瘫患儿进行分级：5例患儿为GMFCSⅠ级,9例患儿为GMFCSⅡ级;比较不同级别的脑瘫患儿之间mf VEP的差异。结果 脑瘫组的mf VEP波形变化趋势与对照组类似：其振幅从离心度第1环至第6环逐渐下降,其潜伏期则逐渐延长。与对照组相比,脑瘫组在第1环至第3环左、右眼振幅下降,差异有统计学意义（P〈0.05）。脑瘫组左眼潜伏期在第1环延长,差异有统计学意义（P=0.045）。比较脑瘫儿童GMFCSⅠ级组与GMFCSⅡ级组,发现两组间振幅在第1环上差异具有统计学意义（P=0.043）,其他结果差异无统计学意义（P〉0.05）。结论 通过多焦视觉电生理技术,发现脑瘫患儿mf VEP波与对照组之间存在差异,提示脑瘫患儿存在视觉通路损害。mf VEP的结果为揭示脑瘫患儿视觉障碍提供客观的理论依据。Objective To evaluate the differences of visual evoked potentials （amplitudes and latency） between cerebral palsy （CP） children and normal children. Methods This study involved fourteen children aged from 4 to 7 years with CP （monoplegia） between 2009 and 2013. Another 14 normal children aged from 5 to 9 years treated in the Department of Ophthalmology in West China Hospital during the same period were regarded as the control group. Both eyes of all the participants were examined by multifocal visual evoked potential （mfVEP）. The mfVEP examination results were recorded, and amplitude and latency were analyzed. First, we analyzed the differences of amplitudes and latency time between monoplegia children and children in the control group. Second, gross motor function classification system （GMFCS） was used to classify the fourteen monoplegia children among whom there were five GMFCS [ patients and nine GMFCS I1 patients. The differences of mfVEP were analyzed between the two GMFCS groups. Results The amplitude and latency of mfVEP in children with CP showed gradual changes similar to those in the normal children. The amplitudes were decreasing and the latencies were delaying from the first eccentricity to the sixth eccentricity. The amplitudes in children with CP were lower than those in the control group in the first to the third eccentricities for both eyes （P 〈 0.05）, and latency of left eye was delayed in the first eccentricity in children with CP （P=0.045）. No difference was found between the two GMFCS groups （P 〉 0.05） except the amplitude of the first eccentricity （P=0.043）. Conclusions The results of mfVEP show significant differences of amplitude and latency between CP and normal children, suggesting the existence of visual pathway impairments in cerebral palsy children. The results of mfVEP can provide an objective basis of visual impairments for cerebral palsy children.

关 键 词：脑性瘫痪 多焦视觉诱发电位 粗大运动功能分级系统 

分 类 号：R742.3[医药卫生—神经病学与精神病学]