体感诱发电位和改良脑出血量表在脑出血患者肢体运动功能康复中的预测价值

目的 探讨体感诱发电位(SEP)和改良脑出血量表(MICH)在脑出血患者肢体运动功能康复中的预测价值. 方法 对自2008年3月至2010年3月在怀化医专附属医院神经内科住院治疗的82例急性期脑出血患者进行SEP检测及MICH量表评分,在患者出院后1月、3月及6月应用改良Rankin量表(MRS)对患者肢体运动功能进行评估,以对SEP及MICH的预测价值进行评价. 结果 ZentnerⅡ级、MICH量表≥3分患者MRS量表评分在出院后1月、3月及6月时均明显高于Zentner Ⅰ级、MICH量表＜3分患者,差异有统计学意义(P＜0.05).Zentner分级及MICH量表预测患者预后不良(MRS评分≥4分)的敏感性分别为74.2％、83.9％,特异性分别为86.3％、88.2％,阳性预测值分别为76.7％、81.3％,阴性预测值分别为84.6％、90.0％.Logistic回归分析显示ZentnerⅡ级及MICH量表≥3分均与患者预后不良相关. 结论 SEP及MICH量表均能对急性期脑出血患者肢体运动功能康复进行预测,临床上将二者结合使用,有利于早期制订康复计划,促进患者康复.

Somatosensory evoked potential and modified cerebral hemorrhage scale in prognosing the extremity function of patients with intracerebral hemorrhage

Objective To explore the value of somatosensory evoked potential (SEP) and modified cerebral hemorrhage (MICH) scale in prognosing the extremity function of patients with intracerebral hemorrhage (ICH).Methods Eighty-two patients with ICH were measured with SEP and MICH,and modified Rankin scales (MRS) was performed to evaluate the extremity function at 1,3 and 6 months after discharging from the hospital.The predictive value of SEP and MICH was evaluated.Results MRS scores in patients with Zentner grade-Ⅱ and MICH scores＜3 were much significantly higher than those in patients with Zentner grade-Ⅰ and MICH scores ≥3 at 1,3 and 6 months after discharging from the hospital (P＜0.05).For patients having MRS scores≥4 (unfavourable prognosis),Zentner grading standard and MICH scores had predictive sensitivities for unfavourable outcome of 74.2％ and 83.9％,and specificities of 86.3％ and 88.2％,positive predictive value of 76.7％ and 81.3％,and negative predictive value of 84.6％ and 90.0％.Logistic regression indicated that patients with Zentner grade-Ⅱ and MICH scores ≥ 3 had a poor outcome.Conclusion SEP and M1CH may yield information useful for predicting extremity function of patients with acute ICH.The combination of SEP with MICH scale will benefit the early formulate rehabilitation programme and promote the extremity function recovery.