脑干听觉诱发电位对脑死亡及深昏迷的诊断价值研究

Research on Brain-stem Auditory Evoked Potential(BAEP) Examination for Diagnosis of Brain Death

目的：探讨脑干听觉诱发电位（BAEP）对脑死亡及深昏迷的诊断价值。方法：对46例深昏迷患者进行脑干反射检查及格拉斯哥昏迷量表评分,同时对46例深昏迷患者及30例健康对照进行脑干听觉诱发电位检查,分析刺激引出的波Ⅰ、波Ⅲ及波Ⅴ的波幅及波峰潜伏期。结果：临床判定脑死亡患者29例及深昏迷患者17例,其中24例脑死亡患者（83%）BAEP检查示波Ⅰ、波Ⅲ及波Ⅴ均消失,仅5例患者（17%）能引出波形,动态监测示各波在首次检查2~12h后消失;17例深昏迷患者波Ⅰ、波Ⅲ及波Ⅴ的波幅（0.31±0.17μV,0.34±0.16μV,0.39±0.20μV）及波峰潜伏期（1.81±0.66ms,3.95±0.47ms,5.94±0.27ms）均较健康对照组异常改变（p〈0.05）,其中5例存活患者BAEP检查示波Ⅰ消失,而波Ⅲ及波Ⅴ正常。结论：BAEP检查对于判定脑死亡及深昏迷诊断具有重要意义,有助于判断深昏迷患者预后。

Objective： To explore the diagnosis value of brain-stem auditory evoked potential（BAEP） for brain death and deep coma.Method： We examined 46 deep coma patients by using the brain-stem reflexes and the Glasgow Coma Score（GCS）.All the 46 patients with deep coma were examined by using BAEP.The amplitude and wave peak latency of the waveⅠ,wave Ⅲ and waveⅤ were analysed.Result：29 brain death cases and 17 deep coma cases were diagnosed.BAEP were absent in 24 brain death cases（83%）,while in the remaining 5 patients（17%） waveⅠand（or） wave Ⅲ and（or） waveⅤ were still present,but disappeared in 2~12 hours after the first examination.The amplitude（0.31±0.17μV,0.34±0.16μV,0.39±0.20μV）and peaklatency（1.81±0.66ms,3.95±0.47ms,5.94±0.27ms） of the waveⅠ,wave Ⅲ and waveⅤ were abnormal（P0.05）,compared to the health control cases.Five patients among the 17 deep coma cases were survived which the waveⅠwere absent,while the wave Ⅲ and wave Ⅴ were normal.Conclusion：BAEP examination plays an important role in diagnosing the brain death and deep coma,and contributes to analyse prognosis of deep coma patients.