高血压丘脑出血和壳核出血的体感诱发电位研究

Study on Somatosensory Evoked Potentials of Patients with Hypertensive Thalamus Hemorrhage and Putamen Hemorrhage

检查了8例高血压丘脑出血和9例高血压壳核出血患者的体感谤发电位,17例患者出血侧 P15、N20、P25的绝对潜伏期.N20—P25振幅值和 N20—P25峰间潜伏期的平均值和非出血侧相应值比较,除出血侧 P25振幅平均值明置低于非出血侧外.其余各项均无统计学上的显著性差异(P>0.05).根据17例患者出血侧 SEP 波型特点.可分为5型,即Ⅰ型(消失型)、Ⅱ型(延长型)、Ⅲ型(降低型)、Ⅳ型(选择消失型)和Ⅴ型(正常型)。根据研究发现.P15可能来源于丘脑下部,SEPS 的早期成份可能由丘脑后部产生.17例患者出血侧 SEP 异常型占14例(82.4%).SEP Ⅰ型和Ⅱ型的预后较差,丘脑出血 SEP Ⅰ和Ⅱ型的血肿量较大,壳核出血 SEP 异常型的预后比丘脑出血好,SEP 拟可以作为预后判断的一项参考性客观指标.但 SEP 在脑出血急性期的变化也可与临床好转情况不完全一致.

Somatosensory Evoked Potentials (SEPs) are examined in 8 hypertensive thalamus and 9 putamen hemorrhage patients.Compared the mean values of P15、N20、P25 latencies,N20、P25 peak-to-peak amplitudes and N20—P25 interpeak latencies of the hemorrhaye hemispheres with the non-hemorrhage hemispheres in 17 patients,only the mean values of P25 peak-to peak ampli- tudes of the hemorrage hemispheres are s'gnificantly lower than the non- hemorrhage hemispheres.We find SEPs patterns can be divided into Ⅰ、Ⅱ Ⅲ、Ⅳ and Ⅴ types in 17 patients.We suggest that P15 might originates from an infra-thalams,whereas,the early components of SEPs might be produced in the posterior thalamus.SEPs of 14 patients (82.4%) are the abnormal types.SEPs Ⅰ and Ⅱ types have poor prognoses.The size of hematoma in the thalamus hemorrhage with Ⅰ and Ⅱ types is bigger than the other types.The prognoses of the abnormal types in the putamen hemo- rrhage are better than those in the thalamus hemorrhage.The SEPs can be also considered an objective reference index of prognostic judegment.Howe- ver,the clinical improvement and SEPs types are not completly synchronous in the acute stage of the intracerebral hemorrhage.