脑干听觉诱发电位对重症手足口病神经系统损害的早期诊断价值

目的 探讨脑干听觉诱发电位（brainstem auditory evoked potential,BAEP）对手足口病重症病例神经系统损害的早期诊断价值.方法 本研究通过对297例手足口病患儿进行BAEP检测,之后按照严重程度分级及年龄进行分组比较,手足口病普通病例、年龄＜3岁为A组（n=80）,重症病例重型、年龄＜3岁为B组（n=94）,普通病例、年龄≥3岁为C组（n=38）,重症病例重型、年龄≥3岁为D组（n=85）.回顾性分析各组脑电图（electroencephalogram,EEG）、头部MRI的检测结果,并与BAEP结果进行比较.结果 （1）B组BAEP异常率（18/94,19.15％）高于A组（3/80,3.75％）,D组BAEP异常率（13/85,15.29％）高于C组（1/38,2.63％）,差异有统计学意义（P＜0.05）.（2）B组EEG异常率偏低（2/94,2.13％）,A组无一例EEG异常.（3）D组EEG异常率（49/85,57.65％）高于C组（6/38,15.79％） （P ＜0.05）,且高于D组BAEP异常率.（4）B组MRI异常率（9/94,9.57％）高于A组（1/80,1.25％）（P＜0.05）,D组MRI异常率（9/85,10.59％）高于C组（0）.（5）全部手足口病重症病例重型患儿的BAEP异常率（31/179,17.32％）高于MRI异常率（18/179,10.06％） （P＜0.05）.结论 BAEP检测可为手足口病重症病例神经系统损害的早期诊断提供客观依据.

Value of brainstem auditory evoked potential in early diagnosis of hand,foot and mouth disease with nervous system damage

Objective To investigate the value of brainstem auditory evoked potential （BAEP） in early diagnosis of severe hand,foot and mouth disease （HFMD） with the nervous system damage.Methods BAEP was performed in 297 cases with HFMD.The patients were divided into 4 groups by the HFMD clinical classification and their ages.Group A included the general cases who were younger than three years （n =80）.Group B included the severe cases who were younger than three years（n =94）.Group C included the general cases who were three years or older（n =38）.Group D included the severe cases who were three years or older（n =85）.The electroencephalogram （EEG） and MRI results of patients in the groups were retrospectively studied and the results were compared with that of BAEP.Results （1） The BAEP abnormal rate of group B （18/94,19.15％）was higher than that of group A （3/80,3.75％）,and the BAEP abnormal rate of group D （13/85,15.29％） was higher than that of group C （1/38,2.63％） （P ＜ 0.05）.（2） The EEG abnormal rate in group B was low（2/94,2.13％） and there was no case with abnormal EEG in group A.（3） The EEG abnormal rate of group D （49/85,57.65％） was higher than that of group C （6/38,15.79％） （P ＜0.05）,and higher than the BAEP abnormal rate of group D.（4） The MRI abnormal rate of group B （9/94,9.57％） was higher than that of group A （1/80,1.25％） （P ＜ 0.05）,and the MRI abnormal rate of group D （9/85,10.59％）was higher than that of group C （0）.（5） The BAEP abnormal rate of the children with severe HFMD （31/179,17.32％） was higher than the MRI abnormal rate （18/179,10.06％） （P ＜0.05）.Conclusion BAEP has clinical significance for early diagnosis of severe HFMD with nervous system damage,and can provide objective basis for the diagnosis.