瞬目反射及脑干听觉诱发电位对脑干梗死疗效的评价

Evaluation of curative effect with blink reflex and brain stem auditory evoked potentials in brain stem infarction

目的探讨瞬目反射和脑干听觉诱发电位对脑干梗死患者疗效的评价作用。方法40例经临床症状、体征定位于脑干髓内并经头部MRI检查明确诊断的脑干梗死患者(脑桥梗死31例、中脑梗死4例和延髓梗死5例),分别计算治疗前后瞬目反射各成分的平均潜伏期;观察脑干听觉诱发电位波形及各波潜伏期、峰间期的变化。结果经治疗后40例患者临床症状及体征均有不同程度改善,治疗前后瞬目反射各成分平均潜伏期之间差异无统计学意义(P>0.05);3例脑桥梗死患者R1波恢复正常,临床基本痊愈。治疗前后脑干听觉诱发电位各波潜伏期及峰间期比较,差异亦无统计学意义(P>0.05);治疗后中脑梗死及脑桥梗死患者各有2例恢复正常,临床症状明显好转。结论瞬目反射与脑干听觉诱发电位均能敏感地反映脑干功能的变化,与临床表现具有一致性,但在发病15d内大部分病例的电生理活动不能恢复正常。

Objective To investigate the role of blink reflex （BR） and brain stem auditory evoked potentials （BAEPs） in the evaluation of curative effect in brain stem infarction. Methods Forty patients with brain stem infarction （31 pontile infarction, 4 midbrain infarction, and 5 bulbar infarction） were located by clinical signs and symptoms, and confirmed by head MRI. Mean latency of every blink reflex component pre-and post-treatment were calculated respectively. Observed the wave shape, latency, and inter-peak latency of brain stem auditory evoked potentials. Results After treatment, the patients＇ clinical signs and symptoms were all improved in different degree. There were no significant differences between mean latency of every blink reflex component of pre- and post-treatment （P〉0.05）, R1 wave recovered to normal and clinical manifestations improved in 3 cases with pontile infarction. Compared with brain stem auditory evoked potentials wave latency and inter-peak latency before treatment, the changes after treatment were also not significant （P〉 0.05）. Two patients with midbrain infarction and 2 with pontile infarction were all recovered to normal and clinical symptoms obviously improved. Conclusion Both blink reflex and brain stem auditory evoked poten- tials can sensitively reflect the changes of brain stem function. They are identical with clinical manifestations. In most cases the electrophysiologic activity can not recover to normal within 15 days after onset.