正常压力脑积水患者视觉诱发电位潜伏期与颅压变化的相关性  

Correlation between visual evoked potential latency and intracranial pressure in patients with normal pressure hydrocephalus

作　　者：张洁 马秀丽 刘春艳 滑蓉蓉 邢岩[1] ZHANG Jie;MA Xiuli;LIU Chunyan;HUA Rongrong;XING Yan(不详;Department of Neurology,Aviation General Hospital,Beijing 100012,China)

机构地区：[1]航空总医院神经内科,100012

出　　处：《中国神经免疫学和神经病学杂志》2021年第5期366-369,共4页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的观察正常压力脑积水(NPH)患者放液试验前后视觉诱发电位(VEP)的变化及其与脑脊液初压的相关性。方法纳入航空总医院神经内科2019年01月至2020年01月收治的诊断临床可疑NPH患者28例,根据脑脊液放液试验结果将患者分为放液试验阳性组(n=21)和放液试验阴性组(n=7)。另纳入来自作者医院体检中心的正常体检者16名为对照组。检测NPH患者放液前脑脊液压力。比较NPH患者放液前后VEP的P100潜伏期差异,并比较其与对照组VEP P100潜伏期的差异。采用Pearson相关性分析NPH患者脑脊液压力和VEP P100潜伏期的相关性。结果放液试验阳性组及放液试验阴性组放液前其VEP P100潜伏期与放液后比较均无统计学差异〔(117.28±10.06)ms比(121.50±11.61)ms;t=-0.135,P=0.171;(116.64±9.14)ms比(116.42±6.72)ms;t=0.050,P=0.961〕;放液试验阳性组及阴性组放液前其P100潜伏期均较正常对照组〔(105.37±6.12)ms〕延长(校正P<0.01、P<0.05),而放液试验阳性者和阴性组间比较其P100潜伏期无统计学差异(P>0.05),且放液后两者间比较亦无统计学差异。放液试验阳性组和阴性组放液前脑脊液压力比较无统计学差异〔(144.85±27.76)mmH2O比(139.28±43.53)mmH_(2)O;t=0.398,P=0.694〕。所有NPH患者、放液试验阳性者以及放液试验阴性者其P100潜伏期与脑脊液初压均无相关性(r=0.018,P=0.928;r=0.206,P=0.369;r=-0.429,P=0.337)。结论NPH患者存在视觉通路损害,但其视觉通路损害与脑脊液压力无明确相关性,推测NPH患者视觉通路的损害可能与NPH的其他病理生理改变有关。Objective To investigate the changes of visual evoked potential(VEP)in patients with normal pressure hydrocephalus(NPH)before and after tap test and the correlation between visual pathway damage and intracranial pressure changes.Methods Twenty-eight patients with clinically suspected NPH admitted to the Department of Neurology,General Aviation Hospital from January 2019 to January 2020,were divided into two groups:a positive group(n=21)and a negative group(n=7).In addition,16 normal subjects from the physical examination center of the author's hospital were included as the control group.The cerebrospinal fluid(CSF)pressure of NPH patients was measured before drainage.The P100 latency of VEP in patients with clinically suspected NPH before and after drainage was compared,and the difference between the P100 latency of VEP and the control group was compared.Pearson correlation was used to analyze the correlation between CSF pressure and VEP P100 latency in NPH patients.Results There was no statistically significant difference in the latency of P100[(117.28±10.06)ms vs.(121.50±11.61)ms;t=-0.135,P=0.171;(116.64±9.14)ms vs.(116.42±6.72)ms;t=0.05,P=0.961]before and after tap test in the positive group and the negative group.The latency of P100 in the positive and negative groups was significantly longer than that of the normal control group(105.37±6.12)ms(adjusted P<0.01,P<0.05),but there was no significant difference in the P100 latency between the positive and negative groups(P>0.05).There was no significant difference in CSF pressure between the positive group and negative groups[(144.85±27.76)mmH_(2)O vs.(139.28±43.53)mmH2O;t=0.398,P=0.694).There was no significant correlation between P100 latency and CSF initial pressure in all the patients with clinically suspected NPH,tap test positive group or tap test negative group(r=0.018,P=-0.928;r=0.206,P=0.369;r=-0.429,P=0.337).Conclusions NPH patients have visual pathway damage.However,there is no clear correlation between visual pathway damage and CSF pressure in

关 键 词：脑积水 正常压力 诱发电位 视觉 颅内压 视通路 

分 类 号：R742[医药卫生—神经病学与精神病学]