脑干听觉诱发电位改变对Binswanger病与单纯脑白质疏松症的评估价值

目的探讨Bingswanger病(Bmgswanger'sdisease,BD)脑干听觉诱发电位(brainstem auditory evoked potentials,BAEP)的改变及其临床意义.方法对33例BD患者行BAEP检查,并与27例单纯脑白质疏松症(Leukoaraiosis,LA)和30例健康自愿者作对照,比较两组的差异.结果BD组和单纯LA组BAEP异常率分别为55.6%和87.9%.各波潜伏期及间期BD组分别为Ⅰ(1.75±0.16)ms,Ⅲ(4.30±0.28)ms,V(6.48±0.31)ms,Ⅰ～Ⅲ(2.55±0.24)ms,Ⅲ～V(2.18±0.23)ms,Ⅰ～V(4.73±0.26)ms;单纯LA组为Ⅰ(172±0.18)ms,Ⅲ(4.05±0.24)ms,V(6.02±0.28)ms,Ⅰ～Ⅲ(2.33±0.22)ms,Ⅲ～V(1.97±0.20)ms,Ⅰ～V(430±0.23)ms;正常对照组为Ⅰ(1.70±0.16)ms,Ⅲ(3.87±0.20)ms,V(5.69±0.22)ms,Ⅰ～Ⅲ(2.16±0.16)ms,Ⅲ～V(1.82±0.16)ms,Ⅰ～V(3.98±0.18)ms.Ⅲ、V波潜伏期及各波间期BD组和LA组较正常对照组差异有显著性意义(q=5.57～26.2,P＜0.01),BD组较单纯LA组差异亦有显著性意义(q=7.81～14.6,P＜0.01);三组间I波潜伏期差异无显著性意义(q=0.9～2.38,P＞0.05).结论BAEP的异常反映了BD患者脑干功能损害,并可作为BD患者脑干功能损害检查的敏感指标及与单纯LA鉴别诊断的一个辅助检查方法.

Changes of brainstem auditory evoked potentials and evaluation of Binswanger''''s disease and leukoaraiosis

AIM: To investigate the value of observing the changes of brainstem auditory evoked potentials(BAEP) in assessment of Binswanger' s disease(BD).METHODS: Thirty-three patients with BD, 27 patients with uncomplicated leukoaraiosis(LA) and 30 healthy controls were enrolled in this study to receive BAEP examinations for a comparative analysis.RESULTS: The rates of BAEP abnormalities in BD group and uncomplicated LA group were 55.6% and 87.9% respectively. For wave Ⅰ, Ⅲ and V, the latencies were(1. 75 ±±0. 16), (4.30 +0.28), and (6.48 +0. 31) ms, respectively; the intervals of wave Ⅰ-Ⅲ, Ⅲ-Ⅴ and Ⅰ-V were (2.55 ±0. 24),(2. 18 ±0. 23) and (4.73 +0. 26) ms, respectively in BD group. The corresponding resuhs were (1.72±0.18), (4.05+0.24), (6.02±0.28)ms, and(2.33 ±0. 22), (1.97 +0.20), (4. 30 +0. 23) ms in LA group,and were(1.70±0.16), (3.87 ±0. 20), (5.69 ±0. 22) ms, and(2. 16 +0.16), (1.82 ±0. 16), (3.98 +0. 18) ms in the control group. The latencies of wave Ⅲ and V, and the intervals of all waves in BD group and LA group were significantly different from those in the control group( q = 5.57 -26.2, P ＜ 0.01 ), and between BD group and uncomplicated LA group, the differences were also significant( q = 7.81 - 14.6, P ＜ 0.01 ) . No significant difference was noted in the latencies of wave Ⅰ between the 3 groups (q=0.9-2.38, P＞ 0.05) .CONCLUSION: BAEP abnormalities reflect brainstem impairments in patients with BD, and BAEP examination can sensitively detect the presence of brainstem lesions in BD patients and differentiate BD from uncomplicated LA.