三叉神经体感诱发电位在眼睑痉挛早期诊断中的应用  

Application of trigeminal somatosensory evoked potentials in early diagnosis of blepharospasm

作　　者：张婷[1] 姜丽杰[1] 刘晓阳[1] 于敏[1] ZHANG Ting;JIANG Lijie;LIU Xiaoyang;YU Min(Department of Neurology,the Third People's Hospital of Dalian,Liaoning Province,Dalian 116000,China)

机构地区：[1]辽宁省大连市第三人民医院神经内科

出　　处：《中国医药导报》2019年第26期82-84,92,共4页China Medical Herald

基　　金：辽宁省大连市医学科学研究计划项目（1611042）

摘　　要：目的探讨三叉神经体感诱发电位(TSEP)在眼睑痉挛早期诊断中的应用价值。方法选择2016年11月~2017年6月辽宁省大连市第三人民医院就诊的具有眼睑痉挛早期非痉挛症状的患者73例及健康人群30名分别作为Ⅱ组和Ⅰ组,根据TSEP检测结果将Ⅱ组进一步分为两个亚组,TSEP异常者40例(Ⅱa组),TSEP正常者33例(Ⅱb组)。统计分析各组C(5,6)位点记录的N13~P19峰间期、P19~N30峰间期,N13/P19峰峰幅度、P19/N30峰峰幅度,F(5,6)位点记录的N13′~P19′峰间期、P19′~N30′峰间期,N13′/P19′峰峰幅度、P19′/N30′峰峰幅度。随访1年,观察Ⅱa组及Ⅱb组眼睑痉挛的发生率。结果Ⅱ组与Ⅰ组比较,P19/N30峰峰幅度和P19′/N30′峰峰幅度均增高,差异有统计学差异(P <0.05),其余指标分析差异均无统计学意义(均P> 0.05)。Ⅱa组与Ⅱb组比较,P19/N30峰峰幅度和P19′/N30′峰峰幅度均增高,差异有高度统计学意义(P <0.01),其余指标比较,差异均无统计学意义(均P> 0.05)。随访1年,Ⅱa组眼睑痉挛的发生率高于Ⅱb组,差异有统计学意义(P <0.05)。结论 TSEP可以在眼睑痉挛早期检测出神经核团兴奋性增高,为眼睑痉挛早期诊断提供依据,可以在临床工作中推广应用。Objective To investigate the value of trigeminal somatosensory evoked potential (TSEP) in the early diagnosis of blepharospasm. Methods From November 2016 to June 2017, 73 cases with early non-spasmodic symptoms of blepharospasm admitted to the Third People's Hospital of Dalian were selected and 30 cases of healthy people as group Ⅱ and groupⅠ respectively. According to the testing results of TSEP, patients of group Ⅱ were further divided into two subgroups, 40 cases (group Ⅱa) with abnormal TSEP and 33 cases (group Ⅱb) with the normal TSEP. The peak-to-peak amplitude of N13-P19, P19-N30, N13/P19 and P19/N30 at locus C (5,6), F (5,6) peak-to-peak amplitude at sites N13′-P19′, P19′- N30′, N13′/P19′/N30′ in each group were statistically analyzed. One year of follow-up, the incidence of blepharospasm group Ⅱa and group Ⅱb were observed. Results Compared with group Ⅰ, P19/N30 peak-to-peak amplitude and P19′/N30′ peak-to-peak amplitude of goup Ⅱ were increased, the differences were statistically significant (P < 0.05), the other indicators showed no statistically significant difference (P > 0.05). Compared with group Ⅱb, P19/N30 peak-to-peak amplitude and P19′/ N30′ peak-to-peak amplitude of group Ⅱa were increased, the differences were highly statistically significant (P < 0.01), the other indicators showed no statistically significant difference (P > 0.05). One year of follow-up, the incidence of blepharospasm of groupⅡa was higher than group Ⅱb, the difference was statistically significant (P < 0.05). Conclusion TSEP can detect increased excitability of nerve nucleus group in the early stage of blepharospasm, providing basis for early diagnosis of blepharospasm, and can be popularized in clinical work.

关 键 词：三叉神经体感诱发电位 非痉挛症状 早期诊断 神经核团 眼睑痉挛 

分 类 号：R74[医药卫生—神经病学与精神病学]