脑干听觉诱发电位对亚临床肝性脑病的诊断意义

SIGNIFICANCE OF BRAINSTEM AUDITORY EVOKED POTENTIALS IN THE DIAGNOSIS OF SUBCLINICAL HEPATIC ENCEPHALOPATHY

对不同Child(C)级别肝硬化患者43例进行脑干听觉诱发电位(BAEPs)检查48次,其中42次检查时无肝性脑病临床表现。另以健康人125例作为正常对照(N)。结果见C_2HE_0、C_3HE_0组各波潜伏期进行性延长,其中Ⅲ、V两波潜伏期与N组、C_1HE_0组及两组之间比较均有显著差异(P<0.005～0.05)。如以N组V波潜伏期M+3SD 6.01msec以上作为异常,则本组亚临床肝性脑病的检出率为61.9％。C_3HE_0组7例V波潜伏期>6.50msec,其中3例在3～10日后发生临床肝性脑病。研究结果建议以BAE-PsV波潜伏期>6.00msec作为亚临床肝性脑病的诊断标准;对>6.50msec者可考虑行预防性肝性脑病药物治疗。

Brainstem auditory evoked potentials (BAEPs) was observed in 43 patients with cirrhosis with various grades of Child(C)classification for 48 times, of which on 42 times the patient had no any clinical manifestations of hepatic encephalopathy(HE),and in 125 healthy subjects of 10-70 years as normal control(N).The results showed the latency of all waves of group C2HE0 and C3HE0 prolonged progressively;the lateney of Ⅲ V wave of these 2 groups showed significant difference when compared with N, C1HE0 and each other (p<0.005-0.05);If we considered 6.01 msec, M+3SD of V wave of N as abnormal, the detection rate of subclinical HE was 61.9%.The V wave latency of 7 cases of C3HE0 group was >6.50 msec, of which 3 cases developped. HE after 3-10 days. This study suggests that the V wave latency of BAEPs>6.00 msec may be considered as a criterion of diagnosis for SHE and prophylactic management of HE might be considered when the latency increases to>6.50 msec.