脑干听觉诱发电位与经颅多普勒检查在评价后循环缺血患者临床病情中的价值

目的 探讨后循环缺血患者的脑干神经电活动与脑血流动力学的变化及相关性,评价脑干听觉诱发电位（BAEP）及经颅多普勒（TCD）检查的临床价值.方法 对134例经临床确诊的后循环缺血患者依据临床症状及CT、MRI检查结果分为梗死亚组（58例）和非梗死亚组（76例）,均进行BAEP及经颅多普勒检查,并与健康对照组（60例）进行对比.结果 134例后循环缺血患者中,BAEP异常123例,异常率91.8%,其中脑干型47.2%（58/123）,内耳型22.7%（28/123）,混合型30.1%（37/123）,内耳型均为非梗死亚组.与对照组比较,后循环缺血患者的Ⅴ波峰潜伏期和Ⅲ-Ⅴ波的峰间潜伏期均延长,差异有统计学意义（P＜0.05）.梗死亚组与非梗死亚组比较,Ⅴ波峰潜伏期、Ⅲ-Ⅴ波峰间潜伏期亦延长,差异有统计学意义（P＜0.05）.134例后循环缺血患者中,经颅多普勒异常82例,异常率61.2%,其中梗死亚组异常率（75.8%）高于非梗死亚组（50.0%）,差异有统计学意义（P＜0.05）.结论 BAEP能灵敏地检测出后循环缺血患者的脑干神经功能异常,可部分反映病情的严重程度,经颅多普勒对发现后循环缺血患者的血流动力学异常具有较高的价值,联合应用BAEP和经颅多普勒可为后循环缺血的病情评估提供重要的参考.

The changes of transcranial doppler and brainstem auditory evoked potential in patients with posterior circulation ischemia

Objective To investigate the changes of transcranial doppler and brainstem auditory evoked potential in patients with posterior circulation ischemia (PCI). Methods One hundred and thirty-four patients with PCI were divided into the infarct group(58 cases) and the non-infarct group(76 cases). All patients were examined by transcranial doppler(TCD) and brain-stem auditory evoked potential ( BAEP). Results The abnormality of TCD was detected in 82 cases(61. 2% ). The abnormality rate of TCD in the infraction group(75.8% ) was higher than the non-infarct group(P<0.05). The abnormality of BAEP was detected in 123 cases (91. 8% ) , in which the abnormality rate in brain stem type (47. 2% ) was the highest. The main abnormal findings of BAEP included prolonged peak latency(PL) of Ⅴ waves and prolonged inter-peak Latency(IPL) of Ⅲ-Ⅴ waves. Conclusions TCD may detect the cerebral homodynamic abnormalities sensitively and BAEP may detect the electro-neurophysiologic abnormalities sensitively in patients with PCI. Combined examination of TCD and BAEP contributes to the early diagnosis, assessment and prognosis for PCI.