脑出血患者的体感诱发电位与肢体瘫痪预后的关系

Study on the relationship between somatosensory evoked potential and prognosis of paralytic limbs in patients with intracerebral hemorrhage

目的:探讨短潜伏期体感诱发电位(SEP)在预测脑出血患者瘫痪肢体康复中的应用价值。方法:对50例脑出血患者在发病7d内进行胫后神经SEP检测,比较健、患侧胫神经P40波幅和潜伏期;在病初和发病3个月后进行Barthel指数评定和美国国立卫生研究院卒中量表(NIHSS)评分。结果:5例患者瘫痪侧肢体胫后神经P40未引出,其余45例患者健、患侧体感诱发电位差异有显著性(P<0.01)。在发病后的3个月临床观察发现,5例未引出者与Barthel指数有相关性,即日常生活能力有重度功能障碍。其余45例患者患侧P40波幅、潜伏期与病初、3个月后NIHSS评分、病初Bathel指数有相关性;而与3个月后Barthel指数未见相关性。结论:脑出血患者患侧的体感诱发电位改变明显,在预测脑出血急性期患者肢体运动功能恢复中有一定的价值。

Objective：To explore the applied value of short-latency somatosensory evoked potential （SEP） for predicting the motor functional rehabilitation in patients with intracerebral hemorrhage. Methods： SEP of tibial nerve was checked in fifty patients within 7 days after onset of intracerebral hemorrhage.The length of latency and amplitude of SEP were compared between the healthy and diseased sides. Barthel Index and NIH Stroke Scale（NIHSS） were assessed at the beginning of the onset and in 3 months after onset. Results： The tibial nerve P40 of paralytic limb was not detected in five patients, while there was statistically significant difference between the healthy and paralytic limbs in the rest fourty-five patients. Absence of SEP was found in 5 patients who had severe handicap in daily life in the follow-up study, In the remaining fourty-five patients,the latency and amplitude of P40 in the paralytic limb correlated significantly with Barthel Index and NIHSS statistically at the onset of the stroke. In 3 months after onset, the latency and amplitude of P40 in the paralytic limb were related to NIHSS but not to Barthel Index. Conclusion： SEP change is a useful index for evaluating the motor functional rehabilitation in patients with acute cerebral hemorrhage.