脑桥梗死后瞬目反射的变化及其对预后评估价值的研究  

The Application of Blink Reflex in Prognosis Assessment of Pontine Infarction

作　　者：王春雷 朵慧敏[2] 石秋环 侯友文 卢玲 杨春晓[2] WANG Chun-lei;DUO Hui-min;SHI Qiu-huan;HOU You-wen;LU Ling;YANG Chun-xiao(Department of Neurology,Harbin Second Hospital Heilongjiang Harbin 150036,China;Department of Neurology,the Second Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨市第二医院神经内科,哈尔滨150036 [2]哈尔滨医科大学附属第二医院神经内科,哈尔滨150001

出　　处：《中国临床神经科学》2021年第2期175-178,192,共5页Chinese Journal of Clinical Neurosciences

基　　金：黑龙江省卫生健康委科研项目(编号:2018152)。

摘　　要：目的通过脑桥梗死患者瞬目反射不同时间点的动态变化研究,探讨瞬目反射对脑桥梗死预后评估的价值。方法纳入脑桥梗死患者49例(脑桥梗死组),分别于发病第3、7、14天和1、3个月时给予瞬目反射检查,发病3个月时再根据mRS神经功能评分分为预后良好组(mRS评分≤2分)和预后不良组(mRS评分>2分),同时纳入10例健康成年人为对照组。两组检测方法相同,对比不同时间点瞬目反射R1、R2、R2’波的潜伏期变化。结果脑桥梗死组分别于发病第3、7、14天出现R2及R2’波潜伏期延长,与对照组比较差异均有统计学意义(P<0.05);发病1个月和3个月时潜伏期有所恢复,但梗死侧与健侧比较差异有统计学意义(P<0.05)。R1潜伏期延长不明显,与对照组比较,差异无统计学意义(P>0.05);根据mRS评分进行分组后,预后良好组在发病第3、7天R1、R2及R2’波潜伏期与预后不良组比较,差异无统计学意义(P>0.05);第14天开始,预后良好组R2及R2’波潜伏期恢复先于预后不良组,差异有统计学意义(P<0.05);发病后第1和3个月时,预后不良组R2及R2’波潜伏期未恢复,与预后良好组比较差异有统计学意义(P<0.05)。结论脑桥梗死患者急性期瞬目反射R2及R2’波潜伏期均有所延长,而R1潜伏期无明显延长,发病14 d左右R2及R2’波潜伏期对预后评估是有价值的客观指标。Aim To study the dynamic changes of blink reflex in patients with pontine infarction at different time points,and explore the value of blink reflex in prognosis assessment of pontine infarction.Methods Forty-nine cases with pontine infarction were examined by blink reflex on days 3,7,14,and 1 and 3 months,respectively,according to three months prior to the onset of mRS nerve function score,the cases were divided into a good prognosis group(mRS score≤2)and a poor prognosis group(mRS score>2),and 10 healthy adults as a control group.With the same test method,the latency changes of R1,R2 and R2’waves in blink reflections at different time points were compared.Results The incubation period of R2 and R2’in 49 patients with cerebral pontine infarction was prolonged on days 3,7,14,respectively,and the difference was statistically significant compared with healthy control group(P<0.05).Although the incubation period recovered somewhat at the first month and the third month,the difference was still statistically significant compared with the healthy side(P<0.05).However,R1 incubation period was not significantly prolonged,and the difference was not statistically significant compared with the control group(P>0.05).After grouping according to mRS score,the incubation period of R1,R2 and R2’wave in the group with good prognosis was not statistically significant compared with that of the group with poor prognosis at day 3 and day 7(P>0.05).The latency of R2 and R2’in the group with good prognosis recovered before that of the group with poor prognosis,and the difference was statistically significant(P<0.05).At the 1 st and 3 rd month after onset,R2 and R2’of the group with poor prognosis did not recover from the incubation period of 1 to 3 months,and the difference was statistically significant compared with the group with good prognosis(P<0.05).Conclusion In patients with cerebral pontine infarction,the incubation period of acute blink reflex R2 and R2’was prolonged,while the incubation period of R1 was not sign

关 键 词：脑桥梗死 瞬目反射 潜伏期 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]