椎基底动脉供血不足患者前庭诱发肌源性电位的临床研究

目的探讨椎基底动脉供血不足(VBI)患者的前庭诱发肌源性电位(VEMP)变化特点,探讨其在疾病临床评估中的应用。方法采用双耳短声刺激并记录45例VBI患者及48例健康体检者的P13-N23波潜伏期、波幅变化,并计算出耳间潜伏期差(△P13)、耳间振幅比(SR)。所有受试者均通过经颅多普勒检查筛查是否存在VBI。结果 VBI组中VEMP检查异常的有37例(82.22%),而在正常对照组受试者中,仅有VEMP异常者2例(4.17%)。两组间双耳各波潜伏期、波幅、△P13及SR变化差异均有统计学意义(P<0.05)。VBI组较正常对照组VEMP检查P13-N23波潜伏期延长,波幅不同程度下降,△P13增大,虽然SR有所增大,但幅度相对较小。结论 P13-N23波潜伏期延长与△P13增大可作为VEMP检查判断VBI患者是否存在脑神经传导通路障碍的参考指标。VEMP可作为一种新的诱发电位检查用于辅助判定VBI患者是否存在脑干功能缺损。

Clinical Observation of Vestibular Evoked Myogenic Potentials in Patients with Vertebrobasilar Insufficiency

Objective To explore the feature in changes of vestibular evoked myogenic potentials(VEMP) in patients with vertebrobasilar insufficiency(VBI),and its application of clinical evaluation of the disease.Methods The P13-N23 wave latency,and amplitude changes of the 45 patients with VBI and 48 normal subjects were recorded by using binaural short acoustic stimuli,and then the latency difference between the ears(△P13) and amplitude ratio between the ears(SR) were calculated.All the subjects were screened by transcranial Doppler(TCD) to determine whether they have VBI.Results There were 37 cases(82.22%) whose VEMP was abnormal in the VBI group,but only 2 cases(4.17%) whose VEMP was abnormal in the controls.There were statistically significant differences in wave latency,amplitude,latency,△P13 and SR between the two groups(P<0.05).Compared with the controls,in the VBI group P13-N23 wave latency extended,amplitude decreased to a certain degree,and △P13 enlarged,and SR was also increased but the magnitude was relatively small.Conclusion The extension of P13-N23 wave latency and enlargement of △P13 can serve as the reference index for VEMP examination to determine whether there is disorders of the brain nerve pathways in the VBI patients.And the VEMP can be used as a new checking of the evoked potential to assist us to determine whether there is impairment of the brain stem function.