脑干听觉诱发电位对前庭系统性眩晕的诊断价值研究

目的探讨脑干听觉诱发电位(BAEP)对前庭系统周围性和中枢性眩晕定位诊断的价值。方法对144例临床确诊的前庭系统性眩晕患者进行BAEP检查,观察Ⅰ、Ⅲ、Ⅴ波的潜伏期(PL)、波形分化情况和Ⅴ/Ⅰ波幅比值及Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波峰的潜伏期(IPL)、两耳测间差(ILD)等,并与健康对照组50例进行比较。结果前庭系统性眩晕144例患者中BAEP异常者92例,异常率为63.9%,其中内耳型21/92例(22.8%),表现为Ⅰ波分化不良或波形消失,Ⅰ波PL延长及其后各波相应延长,ILD相应增大;脑干型42例(45.7%),表现为Ⅰ波正常,Ⅲ、Ⅴ波形分化不良或波形消失,Ⅲ、Ⅴ波的PL、Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～ⅤIPL延长,ILD相应增大,Ⅲ～Ⅴ>Ⅰ～Ⅲ;混合型29例(31.5%),各波指标均出现改变。与对照组比较,差异有统计学意义(P<0.05)。结论 BAEP对前庭系统周围性眩晕与中枢性眩晕定位诊断具有临床意义。

Diagnostic value of brainstem auditory evoked pot ential in patients with vestibular system vertigo

Objective To explore the diagnostic value of localization of brainstem auditory evoked potential（BAEP） in the patients with vestibular system peripheral and central vertigo.Methods BAEP was done in 144 patients with vestibular system vertigo and 50 healthy subjects as control.The peak latency（PL） and change of wave Ⅰ,Ⅲ,Ⅴ,the ratio of Ⅴ/Ⅰ,the interpeak latency（IPL） of wave Ⅰ-Ⅲ,Ⅲ-Ⅴ and Ⅰ-Ⅴ and the interear latency difference（ILD） of two ears were observed.Results BAEP was abnormal in 92 cases,the abnormality rate was 63.9%.Three types of abnormality were classified according to their characteristics.The inner-ear type was in 21 cases（22.8%）,showing undifferentiation or disappearance of wave Ⅰ,prolongation of PL of wave Ⅰ and all later waves,increace of IDL,the brainstem type was in 42 cases（45.7%）,showing normal wave Ⅰ,undifferentiation or disappearance of wave Ⅲ and wave Ⅴ,prolongation of PL of wave Ⅲ and wave Ⅴ,also prolongation of IPL of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ,as well as increace of ILD,and the mixed type was in 29 cases（31.5%）,showing abnormalities of all the Ⅰ,Ⅲ,Ⅴ waves,all demonstrating statistical differences in comparison to the contral group（P〈0.05）.Conclusion BAEP has the clinical value in the differentiatial diagnosis between vestibular peripheral and central vertigo.