婴儿痉挛症听觉脑干诱发电位的临床观察

Further Study on Auditory Brain-stem Responses in Infantile Spasms

对长期随访观察的35例婴儿痉挛症(IS)患儿进行听觉脑干诱发电位(ABR)测试和智能发育检查,结合临床症状、转归、疗效等进行综合分析。结果表明:IS患儿ABR的各波潜伏期及其间期均明显长于正常儿童,而且ABR的某些测值与患儿的智能水平密切相关,随着智能发育水平的提高,ABR的中枢传导时间Ⅰ～Ⅴ波间期逐渐缩短。脑干是Is发病的重要相关部位,因此ABR测试对于IS确是一有效监测手段。还发现患儿发病越早,其智能水平越差,ABR的Ⅰ～Ⅴ间期就越长,如痉挛能及早得到控制且智能水平得到提高,ABR值就越接近正常,提示如能尽早终止痉挛,则有益患儿的远期预后。在某种程度上,ABR可作为评价IS患儿智能水平、病情演变以及估计疗效和预后的有效方法。

Intelllgence test and auditory brain-stem response (ABR) were conducted in 35 cases of infantile spasms (IS). The items hsted in the analysis included clinical symptoms .changes of the disease and therapeutic effect-s. The results showed that each wave latency and interpeak interval of the ABR in sick children were obvious-ly longer than those of normal children,and the central conduction time of ABR in IS had negative relevance with the intelligence or developmental quotient (IQ or DQ),through the multi-regression analysis,it revealed that the earher the spasm came on or the longer the spasms lasted,the lower the score of IQ or I)Q,and the later the spasms came on or the earlier to get seizure free,the higher the score of IQ or DQ. To sum up,ABR could be regarded as a useful tooi in prediction of prognosis ,evaluation of drug effects and m some extent in the understandmg of pathophysiology of IS.