ABR对前列地尔治疗椎基底动脉缺血性眩晕的疗效评估

Efficacy evaluation of prostagland E1 in the treatment of senile vertebrobasilar transient ischemic verigoby auditory brainstem response

目的寻找治疗椎基底动脉短暂缺血性眩晕（vertebrobasilar transient ischemic vertigo,VBTIV）的有效药物,为前列地尔治疗VBTIV的临床应用提供客观依据。方法VBTIV患者40例,选用丹麦Madsen公司2260型脑干诱发电位（ABR）系统测试。以短声刺激,刺激声为交替极性,扫描时间10ms,方波脉冲0.1 ms交替短声刺激,感觉级75 dBSL,最大输出为120 dBpeSPL。叠加1 000次,增益至1 200次。滤波带通为100~2 500 Hz,分别给予11次/s的常规ABR测试和51次/s的高刺激率ABR测试。给予前列地尔静脉注射,每日1次,每次10μg,2周后症状缓解,再用同样方法复查ABR。结果应用前列地尔治疗14 d后,40例患者中30例完全缓解占75%。2例部分缓解,8例无缓解。以51次/s ABR与11次/s的ABR差值作为分析参数,治疗前后的组群对比和同一患者自身对比,除了波Ⅰ潜伏期两者无差异外（P〉0.05）,其余的波潜伏期及波间期,治疗后较治疗前缩短,有统计学意义（P〈0.05）。结论高刺激率ABR可作为前列地尔治疗VBTIV疗效评估的一个客观指标,前列地尔是治疗VBTIV的有效药物,值得临床推广应用。

Objective To look for the effective medicine for treating senile vertebrobasilar transientischemic vertigo （VBTW）, and to provide objective proofs for clinical application of prostngland El to treat VBTIV. Methods Forty VBTIV patients （age range, 40 - 58 yr） were detected by 2260 type ABR system which was made by MadsenCompany in Denmark. The stimulus ear was applied to alternative click. Their thresholds of the two ears were recorded. Parameters： hearing level： 75 dBSL; the largest output： 120 dBpeSPL; The stimulus frequency： 11/sec, 51/see.These patientswere given PGEI 10 μg once daily by intravenous injection. ABR was examined with the same method again after the patientswere treated with PGEI for two weeks. Results Among 40 patients,30 pa tients（75% ） were completely recoveredafter the treatment. 2 cases were partially improved and 8 cases were not improved. The distinction of 51/sec ABR and 11/secABR were recorded.Eexcpt for wave Ⅰ peak latency,the wave peak latency and wave interpeak latency were obviously shortened （ P 〈 0.05）.Conclusion High stimulation frequency ABR can be used as an objective index of efficacy evaluationof PGEI in the treatment of senile VBTIV. PGEI is an effective drug to treat senile VBTIV, which is worthy to be widely applied in clinic.