听性脑干反应在诊断脑干放射性损害中的意义

AUDITORY BRAINSTEM RESPONSE IN THE DIAGNOSIS OF RADIATION DAMAGE OF THE BRAISTEM

目的：为探讨听性脑干反应（ＡＢＲ） 对脑干放射性损害的诊断价值。方法：对放射性脑干脊髓病６ 例（１２ 耳） 、放疗后１ 年的鼻咽癌（ＮＰＣ） 患者１８ 例（３６ 耳） 和正常对照１５例（３０ 耳） 进行了ＡＢＲ 检测。结果：①放射性脑干脊髓病６ 例均有ＡＢＲ 异常，主要表现有ⅠⅢ，ⅢⅤ及ⅠⅤ间期明显延长、未引出ＡＢＲ 或波Ⅰ以后各波消失；②ＮＰＣ 患者放疗后１ 年ⅢⅤ和ⅠⅤ间期均值较放疗前明显延长（ Ｐ＜ ０ ．０１） 。结论：ＡＢＲ 是检测脑干通路病变的敏感指标，对脑干放射性损害的诊断有一定意义。

Objective: To investigate the clinical value of auditory brainstem response (ABR) in the diagnosis of radiation damage of the brainstem. Methods: ABR was detected in 6 patient (12 ears) with radiation myelopathy of the brainstem, 18 patients (36 ears) with nasopharyngeal carcinoma (NPC) and 15 normal controls (30 ears). Results: ①Abnormal ABR included the prolongation of wave Ⅰ Ⅲ, Ⅲ Ⅴ andⅠ Ⅴ interpeak latency intervals, no response by ABR or the disappearance of other waves after wave Ⅰ. Abnormal ABR was found in all patients with radiation myelopathy of brainstem; ②The mean value of wave Ⅲ Ⅴ and Ⅰ Ⅴ interpeak lancey intervals were significantly prolonged ( P <0.01) in patients with NPC 12 months after radiotherapy. Conclusion: The ABR detection is one of sensitive indication in brainstem neuropathology. It is useful for the diagnosis of radiation damage of the brainstem. [