TIA后下肢短潜伏期体感诱发电位动态变化的临床观察

目的动态测定短暂性脑缺血发作(TIA)患者双下肢短潜伏期体感诱发电位(short-1atency somatosensory e-voked potential,SLSEP),探讨其变化意义。方法以P40、N8和N50潜伏期的数值差为观察指标,分别对51例住院的TIA患者在入院时及发病30 d后进行双下肢SLSEP的检测。根据30 d内是否发生脑梗死,将患者分为A组(TIA无脑梗死组)34例与B组(脑梗死组,病前有TIA史)17例进行比较分析。结果 TIA患者下肢SLSEP的检查中以P40的改变具有临床意义,有66.7%(34/51)的TIA患者入院时P40潜伏期差值出现异常。A组中,16例有TIA再发,其中N8、N50和P40潜伏期的数值差30 d后均略为降低,但差异无统计学意义。脑梗死出现在TIA后2 d内3例(5.9%,3/51),7 d内2例(3.9%,2/51),1个月内12例(23.5%,12/51)。B组30 d后P40潜伏期的数值差不仅较入院时明显延长(F=12.9,P<0.05),且和A组30 d后的值相比差别有统计学意义(F=4.35,P<0.05)。结论 TIA中短期发展为脑梗死的患者P40潜伏期差值明显延长,下肢SLSEP中P40的检测或为观察TIA患者的病情演变提供了一个新的思路,相对于上肢SLSEP的检测,P40更为方便,值得临床推广或进行深入研究。

Dynamic Changes of Lower Limb Short-latency Somatosensory Evoked Potential after Transient Ischemic Attack

Objective To determine the dynamic changes of both lower limbs short-latency somatosensory evoked potential(SLSEP) after transient ischemic attack(TIA) and evaluate its clinic significance.Methods The routine SLSEP of 51 patients with TIA were checked when they were admitted in hospital and 30 days later,and the dynamic changes of P40,N8 and N50 latency difference of abnormal value of SLSEP was analyzed.The patients were divided into group A(TIA group without cerebral infarction,34 cases) and group B(stroke-after-TIA group,17 cases) based on the follow-up visits.Results The changes of P40 in TIA patients had its clinic significance,66.7%(34/51) patients of TIA were with abnormal P40 latency difference when they were on admission.In group A,16 cases were recurred with TIA,the value of N8,N50 and P40 latency difference was decreased after 30 days,but they showed no statistical significance.In group B,3 patients(5.9%,3/51) had occurred cerebral infarction after 2 days in TIA,2 cases(3.9%,2/51) had occurred after 7 days,and the other 12 cases(23.5%,12/51) had occurred within 30 days.They exhibited apparent extension of P40 latency difference comparing with initial(P<0.05),and significant differences of P40 latency difference between two groups were observed after thirty days(P<0.05).Conclusion The latency difference of P40 value in cerebral infarction has extended obviously after TIA in short times(<30 days).A new thread maybe supplied by the detection of P40 of lower limb SLSEP of TIA.P40 may be a simpler method as comparing with the upper limb SLSEP.