急性一氧化碳中毒后迟发性脑病患者下肢体感诱发电位的研究

Study the lower limber somatosensory evoked potentials in patients with delayed encephalopathy after acute carbon monoxide poisoning

目的探讨急性一氧化碳（CO）中毒后迟发性脑病（DEACMP）患者下肢体感诱发电位（SEPs）的变化。方法对40例DEACMP患者（病例组）和32名健康成人（正常对照组）进行SEPs的N22、P40、N50、P60、N75各波潜伏期和N22~P40峰间期测量。结果病例组30例（75%）患者出现下肢SEPs异常,皮质电位各波潜伏期分别为P40（41.92±2.49）ms、N50（52.13±4.29）ms、P60（64.37±4.98）ms、N75（80.84±4.73）ms,较对照组显著延长（均P〈0.01）,腰髓诱发电位两组间差异无统计学意义。治疗3个月后,10例SEPs正常的患者总有效率为100%（10/10）,30例SEPs异常患者的总有效率为86.7%（26/30）,两者差异有统计学意义（P〈0.01）。结论DEACMP患者下肢SEPs的变化对病情及预后判断有一定价值,其中皮质电位的变化较腰髓电位敏感。

Objective To evaluate the changes of the lower limber somatosensory evoked potentials （SEPs） in patients with delayed encephalopathy after acute carbon monoxide poisoning. Methods The tibial nerve SEPs were performed in 32 healthy adults and 40 patients with delayed encephalopathy after acute carbon monoxide poisoning. Wave N22, P40, N50, P60, N75 latency and N22 - P40 interpeaklatencies were measured, respectively. Results 30 patients （75%） indicated abnormalities of tibial nerve SEPs. The latencies of cortical potential of wave P40 [ （41.92 ± 2.49） ms], N50 [ （52.13 ± 4.29） ms], P60 [ （64.37 ± 4.98） ms] and N75 [ （80. 84 ± 4.73 ） ms] in patient group were longer than those in control group （ all P 〈 0. 01 ）. There was no difference about the lumbar spinal cord potentials between the two groups. After 3 months of treatments, the total effective rate was 100% in 10 patients with normal SEPs and 86.7% in patients with abnormal SEPs. The difference was significant between the two groups （P 〈0. O1 ）. Conclusions These results show that SEPs may be used for evaluating the degree and prognosis in eases of delayed eneephalopathy after acute carbon monoxide poisoning, and cortical potential is more sensitive than lumber spinal cord potential.