急性白血病患者中枢神经系统诱发电位及认知功能测定

Determination of evoked potential and cognitive function in patients with acute leukemia

目的探讨脑干听觉诱发电位（BEAP）、视觉诱发电位（VEP）及视觉保持测验（VRT）在检测急性白血病患者中枢神经系统功能损伤中的作用。方法采用日本光电Neuropack-M1型肌电图／诱发电位仪对30例急性白血病患者（白血病组）及的30例健康者（对照组）进行BEAP、VEP检测，同时采用龚氏修订的视觉保持测验（VRT）进行认知功能检测。结果白血病组BEAP异常率23．3％，Ⅲ、Ⅴ波峰潜伏期（PL）、Ⅰ—Ⅴ波峰间期（IPL）延长与对照组比较差异有统计学意义（P〈0．05）；白血病组VEP异常率26．7％，主要表现为P100PL延长，与对照组比较差异有统计学意义（P〈0．05）；白血病组VRT异常率33．3％，其中E式D法正确分和错误分与对照组比较差异有统计学意义（P〈0．05）。结论BEAP、VEP及VRT可敏感发现急性白血病患者的中枢神经系统功能损伤，为早期诊断中枢神经系统白血病提供线索。

Objective To explore the value of brainstem auditory evoked potential（BAEP）,visual evoked potential（VEP） and Revised Visual Retention Test（VRT） in detecting impairment of central nervous system in patients with acute leukemia（AL）. Methods Neuropack-M1 type evoked potential machine （Japan） was used to check brainstem auditory evoked potential（BAEP） and visual evoked potential（VEP）. BAEP, VEP and VRT were examined in 30 cases with acute leukemia（ group AL） and in 30 age and sex matched healthy subjects as a control（groupC）. Indexes of BAEP including peak latency（PL） of waves Ⅰ , Ⅲ, Ⅴ and inter-peak latency（IPL） of waves Ⅰ- Ⅲ, Ⅲ - Ⅴ, Ⅰ - Ⅴ and indexes of VEP（P10OPL） were determined. VRT was accomplished meanwhile applying B method with C pattern, C method with D pattern, D method with E pattern. The correct scores and error scores were recorded separately. Results BAEP： the abnormal rate of the group AL was 23.3 %. Compared with control group, we found significant longer latency of wave Ⅲ, Ⅴ （ P 〈 0.05 ） and significant elongation in the mean inter-peak latencies of Ⅰ - Ⅴ （ P 〈 0. 05 ）. VEP： the abnormal rate of the group AL was 26.7%, the P100 PL of the patients was longer than that in the control group（ P 〈 0. 05 ）. VRT ： the abnormal rate of the group AL was 33. 3%. The results of VRT showed that the score in the group AL in D method with E pattern was lower than that in the control group（ P 〈 0.05 ）. Conclusion BEAP, VEP and VRT could detect the impairment of central nervous system in patients with acute leukemia sensitively, and give clues to early diagnosis of central nervous system leukemia（ CNSL）.