轻中型脑外伤脑干听觉诱发电位初步研究

目的 :探讨轻中型脑外伤脑干听觉诱发电位(BAEP)的变化。方法 :应用BAEP检测、分析127例轻中型脑外伤的变化。结果 :EAEPⅠ -Ⅲ ,Ⅰ -Ⅴ峰间期延长 ,V波潜伏期延长 ,Ⅲ -Ⅴ/Ⅰ -Ⅲ>1。结论 :轻中型脑外伤患者存在脑功能损伤。BAEP是评价其损伤较敏感的客观指标。     

针刺治疗轻中型颅脑损伤患者的脑干听觉诱发电位

目的:观察针刺治疗轻中型颅脑损伤患者的疗效及对脑干听觉诱发电位(BAEP)的影响。方法:60 例轻中型颅脑损伤患者分为2组各30例,均采用综合康复治疗,针刺组加用针刺治疗。治疗前后对肢体运动功 能、日常生活能力及脑电生理进行评定,并与正常组对照。结果:治疗后Fugl Meyer评分及Barthel指数2组均明 显提高;BAEP异常率治疗前为76.7%,治疗后为46.7%,与常规组比较,针刺组V波峰潜伏期、Ⅲ Ⅴ和I Ⅴ峰间 潜伏期改善更显著(P<0.05)。结论:针刺治疗可改善轻中型颅脑损伤患者的运动功能及脑干神经传导功能。     

脑干听觉诱发电位对重型颅脑损伤植物状态评估的价值

目的研究脑干听觉诱发电位 (BAEP)对重型颅脑损伤植物状态患者脑干功能的评估以及对预后判断的价值。方法对 30例重型颅脑损伤植物状态患者在综合康复治疗前及治疗 1个月后行BAEP检查及格拉斯哥昏迷量表 (GCS)评分。 6个月后进行随访 ,行格拉斯哥预后量表 (GOS)评分并复查BAEP。分析BAEP分级与GCS评分、GOS评分的关系以及清醒前后BAEP变化的特点。结果康复治疗前BAEP异常率为 93.3% ( 2 8/30例 ) ,康复治疗 1个月后BAEP异常率为 86 .7% ( 2 6 /30例 ) ,其中Ⅳ级减少 5例 ( 16 .7% ) ,而Ⅰ级增加 2例 ( 6 .7% )。BAEP分级越高 ,则预后越差。有 12例 ( 4 0 % )患者意识恢复 ,意识改善后BAEP的主要变化是Ⅴ波的出现 ,其次是各波分化的改善和潜伏期的缩短。结论BAEP检测可评估重型颅脑损伤植物状态患者脑干功能并为预后判断提供依据。Ⅴ波的出现提示脑干功能的恢复 ,是意识改善的脑电生理学指标     

糖尿病脑干听觉诱发电位分析

目的探讨脑干听觉诱发电位(BAEP)对糖尿病患者脑干功能损害的评定价值。方法对30例临床诊断为2型糖尿病的患者进行BAEP检测,并与20例正常组进行对照分析。结果糖尿病患者BAEP的异常率为63.33%,并与其病程呈正相关,但与血糖浓度无相关性。其中Ⅲ、Ⅴ波潜伏期(PL),Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ峰间期(IPL)较正常组延长,Ⅲ、Ⅴ波波幅降低,均有显著性差异(P<0.05)。结论BAEP对糖尿病脑干亚临床功能异常的诊断有重要意义。     

脑干听觉诱发电位在儿童脑外伤后综合征诊断中的应用

[目的]探讨脑干听觉诱发电位（BAEP）对儿童脑外伤后综合征（PTBS）诊断价值.[方法]对照分析24例PTBS患儿与24例正常儿童的BAEP的Ⅰ、Ⅲ、Ⅴ波峰潜伏期（PL）,Ⅰ~Ⅲ、Ⅲ~Ⅴ峰间潜伏期（IPL）的差异.[结果]PTBS患儿BAEPⅠ波PL与对照组相比差异无显著意义（P〉0.05）.BAEP其他波PL及IPL均延长,与对照组有显著差异（P＜0.05）.[结论]BAEP筛查有助于PTBS患儿的早期发现.     

帕金森病脑干听觉诱发电位分析

目的了解帕金森病(PD)是否存在脑干听觉传导通路的损害。方法PD患者及正常对照组各15例。使用英国OXFORD公司的Medelec034W11B-V4.0多媒体肌电/诱发电位仪,进行脑干听觉诱发电位(BAEP)检测。主要观察Ⅰ、Ⅲ、Ⅴ波的峰潜伏期(PL),及Ⅰ-Ⅴ、Ⅰ-Ⅲ、Ⅲ-Ⅴ波的峰间潜伏期(IPL),双耳PL及IPL的耳间差(ILD),Ⅴ/Ⅰ波幅比值,及波形分化。结果PD患者BAEP异常率为3/15。异常者3例均Ⅲ-Ⅴ/Ⅰ-ⅢIPL>1。PD组Ⅴ波PL、Ⅰ-Ⅴ波IPL、Ⅲ-Ⅴ波IPL分别为(5.82±0.4)、(4.08±0.3)、(1.91±0.29)ms,对照组分别为(5.50±0.27)、(3.86±0.28)、(1.68±0.16)ms,两组比较差异均有显著性意义(P<0.01)。PD组的Ⅴ/Ⅰ波幅比值与对照组比较无统计学差异(P>0.05)。PD组BAEP异常率与性别、年龄及病程无统计学差异(P>0.05)。结论PD存在脑干听觉传导通路中枢段(高位脑干)损害,与年龄、病程等无关。BAEP检查可早期发现这一损害,可能作为评定PD患者病情敏感而客观的指标。R     

轻中型脑外伤脑干听觉诱发电位初步研究

目的：探讨轻中型脑外伤脑干听觉诱发电位（ＢＡＥＰ）的变化。方法：应用ＢＡＥＰ检测、分析１２７例轻中型脑外的变化。结果：ＢＡＥＰⅠ－Ⅲ,Ⅰ－Ⅴ峰间期延和Ⅳ波潜伏期延长,Ⅲ－Ⅴ／Ⅰ－Ⅲ〉。结论：轻中型脑外伤患存在脑功能损伤。ＢＡＥＰ是评价其损伤较敏感的客观指标。     

2型糖尿病患者脑干听觉诱发电位改变及其相关因素分析

[目的]探讨2型糖尿病患者听力损害的特点及与各临床因素之间的关系.[方法]测定132例2型糖尿病患者及40例健康人的脑干听觉诱发电位(BAEP).其中病例组按病程分为病程＜5年(A组)、5年≤病程＜10年(B组)、病程≥10年(C组),分析影响听力的危险因素.[结果]①B、C组的Ⅰ、Ⅲ波的潜伏期(PL),Ⅰ~Ⅲ波的峰间潜伏期(IPL)较对照组明显延长,C组的Ⅰ、Ⅲ波的PL,Ⅰ~Ⅲ波的IPL较A组明显延长( P <0.05),左右耳均无明显差异( P >0.05).②A组BAEP异常12例(26.67%),B组BAEP异常16例(35.56%),C组的BAEP异常28例(66.67%),组间差异有统计学意义( P <0.05).③周围神经病变严重组(病变神经数＞4条)的Ⅰ波的PL、Ⅰ~Ⅴ波的IPL较周围神经病变较轻组(病变神经数≤4条)明显延长( P ＜0.05).④病程、糖化血红蛋白是2型糖尿病患者听力损害的危险因素,病程与BAEP的Ⅰ、Ⅲ波的PL呈正的直线相关关系.[结论]BAEP是检测糖尿病患者听觉功能异常的有效方法,积极进行听力学检测有助于糖尿病患者听力损害的早期诊断和干预治疗.     

脑干损伤病人的脑干反射和脑干听觉诱发电位研究

目的 :探讨脑干反射 (BSR)和脑干听觉诱发电位 (BAEP)在观察脑干损伤病人的病情变化、判断预后方面的价值。方法 :对 70例脑干损伤病人同时进行BSR、BAEP监测。分析BSR、BAEP与格拉斯哥昏迷计分 (GCS)、格拉斯哥预后分级 (GOS)之间的关系以及 2 5例临终状态时BSR、BAEP情况 ,同时研究早期脑疝病人的BAEP变化。结果 :BSR、BAEP与病人的GCS、GOS密切相关 ,BSR平面越低 ,病情越重 ,预后越差 ;BAEP异常程度与病情轻重基本一致 ,双侧或一侧Ⅰ、Ⅲ、Ⅴ波平坦 ,提示预后不佳。脑死亡者绝大多数BSR属Ⅵ平面 ,BAEP双侧各波呈电平坦。脑疝早期BAEP主要表现为一侧波Ⅴ消失或波Ⅰ～Ⅴ、Ⅲ～Ⅴ峰间潜时 (IPL)延长。结论 :BSR、BAEP可用来观察病情、判断预后 ,可作为脑死亡的诊断标准之一 ,BAEP有助于早期发现脑疝 ,指导治疗     

帕金森病脑干听觉诱发电位分析

目的 了解帕金森病（PD）是否存在脑干听觉传导通路的损害。方法 PD患者及正常对照组各15例。使用英国OXFORD公司的Medelec034W11B-V4.0多媒体肌电／诱发电位仪，进行脑干听觉诱发电位（BAEP）检测。主要观察Ⅰ、Ⅲ、Ⅴ波的峰潜伏期（PL），及Ⅰ-Ⅴ、Ⅰ-Ⅲ、Ⅲ-Ⅴ波的间潜伏期（IPL），双耳PL及IPL的耳间差（ILD），V／I波幅比值，及波形分化。结果 PD患者BAEP异常率为3／15。异常者3例均Ⅲ-Ⅴ/Ⅰ-Ⅲ IPL&;gt;1。PD组Ⅴ波PL、I－V波IPL、Ⅲ-Ⅴ波IPL分别为（5.82&;#177;0.4)、（4.08&;#177;0.3)、（1.91&;#177;0.29)ms，对照组分别为（5.50&;#177;0.27)、（3.86&;#177;0.28)、（1.68&;#177;0.16)ms，两组比较差异均有显著性意义（P＜0.01)。PD组的V／I波幅比值与对照组比较无统计学差异（P＞0.05)。PD组BAEP异常率与性别、年龄及病程无统计学差异（P＞0.05)。结论 PD存在脑干听觉传导通路中枢段（高位脑干）损害，与年龄、病程等无关。BAEP检查可早期发现这一损害，可能作为评定PD患者病情敏感而客观的指标。     

Acquired predisposition to mycobacterial disease due to autoantibodies to IFN-gamma

Genetic defects in the IFN-gamma response pathway cause unique susceptibility to intracellular pathogens, particularly mycobacteria, but are rare and do not explain mycobacterial disease in the majority of affected patients. We postulated that acquired defects in macrophage activation by IFN-gamma may cause a similar immunological phenotype and thus explain the occurrence of disseminated intracellular infections in some patients without identifiable immune deficiency. Macrophage activation in response to IFN-gamma and IFN-gamma production were studied in whole blood and PBMCs of 3 patients with severe, unexplained nontuberculous mycobacterial infection. In all 3 patients, IFN-gamma was undetectable following mitogen stimulation of whole blood, but significant quantities were detectable in the supernatants of PBMCs when stimulated in the absence of the patients' own plasma. The patients' plasma inhibited the ability of IFN-gamma to increase production of TNF-alpha by both autologous and normal donor PBMCs, and recovery of exogenous IFN-gamma from the patients' plasma was greatly reduced. Using affinity chromatography, surface-enhanced laser desorption/ionization mass spectrometry, and sequencing, we isolated an IFN-gamma-neutralizing factor from the patients' plasma and showed it to be an autoantibody against IFN-gamma. The purified anti-IFN-gamma antibody was shown to be functional first in blocking the upregulation of TNF-alpha production in response to endotoxin; second in blocking induction of IFN-gamma-inducible genes (according to results of high-density cDNA microarrays); and third in inhibiting upregulation of HLA class II expression on PBMCs. Acquired defects in the IFN-gamma pathway may explain unusual susceptibility to intracellular pathogens in other patients without underlying, genetically determined immunological defects.     

Immunoglobulin administration to fetuses with anemia due to alloimmunization to D

BACKGROUND: The purpose of this study was to examine fetal tolerance of high-dose intravenous immunoglobulin (IVIG), given directly at the time of intravascular transfusion, and its effects on fetal hemolysis and pregnancy outcome in the setting of alloimmunization to D.
STUDY DESIGN AND METHODS: Thirteen consecutive D+ fetuses requiring transfusion for maternal alloimmunization received high-dose IVIG (1.0 g/kg) and red cell transfusions. Twenty-four previous, consecutive fetuses with maternal anti-D served as controls. The schedules for subsequent transfusions were the same in the two groups.
RESULTS: High-dose IVIG was well tolerated by all fetuses. In the IVIG group, daily decreases in hematocrit were smaller than those in controls after the second administration of IVIG (mean hematocrit decrease, 0.72 percent/day vs. 1.45 percent/day; p = 0.007). No significant difference was found in the total number of fetal transfusions, the gestational age at delivery, the duration of neonatal intensive care, the number of neonates requiring postnatal transfusion therapy, and perinatal mortality.
CONCLUSION: In this small pilot study, direct administration to fetuses of IVIG with red cell transfusions was well tolerated and appeared to have a beneficial effect on fetal hemolysis.