脑梗塞的体感诱发电位与临床的研究

A clinical study on the short-latency somatosensory evoked potentials in 100 patients with cerebral infarction

对 10 0例脑梗塞患者进行双下肢短潜伏期体感诱发电位 (SLSEP)检测 ,同时记录患者的肢体功能障碍情况、头颅CT所示的梗塞灶部位和大小范围 ,对其中的重度异常的 2 0例经治疗后进行复查 ,分析和比较它们之间的关系。结果显示 :72 %的患者SLSEP异常 ,2 8%正常。其中重度异常 (表现为引不出可辨认之波形 ) 2 0例 ,轻～中度异常 (表现为病侧半球SLSEPP4 0 ～N75波幅较对侧降低 5 0 %以上 ,或P4 0 潜伏期较健侧延长 2 .90ms以上 ,或SLSEP各波峰潜伏期延长超过正常对照值 ) 5 2例。临床查出有感觉障碍者 (40例 )SLSEP异常 3 6例 (异常率 90 % ) ,无感觉障碍者 (60例 )SLSEP异常 3 6例 (异常率 60 % )。 2 0例复查时SLSEP有改善者 12例 ,肢体功能恢复得较好 ;8例无变化 ,恢复较差。认为SLSEP异常可作为评价脑梗塞患者肢体功能障碍的客观电生理证据 ,特别是体感通路受损的客观证据。但部分病人肢体功能障碍与SLSEP无明显关联。动态观察SLSEP有助于对肢体功能障碍恢复的判断。

The short-latency somatosensory evoked potentials (SLSEP) in the two limbs from 100 patients with cerebral infarction were examined and the limb function, the infarct locations and their sizes through CT scanning were recorded at the same time. Twenty of them with severe abnormity were reexamined after treatment and their relationship was analyzed and compared to each other. Results showed that 72% of the patients were with abnormal SLSEP and 28% with the normal one. Twenty of them were with severe abnormity ( the identifying undulate form could not be drawn forth). Fifty-two of them with light to middle degree of abnormity (the wave amplitude of SLSEPP 40～N 75 in the diseased hemisphere side decreasing over 50% in comparison with the opposite side, or the P40 latency prolonged over 2.90ms in comparison with the healthy side, or the prolonging of each spike latency of the SLSEP surpassed the normal value). In clinical examination, 40 patients were found with sensory disorders, and thirty-six of them with abnormal SLSEP (the abnormal rate was 90%); sixty without sensory disorders, and thirty-six of them with abnormal SLSEP (the abnormal rate was 60%). During reexamination for twenty patients, the SLSEP in twelve of them improved significantly and their limb function recovered better. The diseased condition in eight patients remained the same and got worse recovery. This study indicated that the abnormal SLSEP could be regarded as an objective provement for the evaluation of the limb function disorder in patients with cerebral infarction, especially for the somatosensory injury. But the limb function disturbance in part of the patients had no obvious relation with SLSEP. The dynamic observation of SLSEP can help to judge the recovery of limb function disturbance.