瞬目反射联合脑干听觉诱发电位检查在后循环缺血诊断中的应用

Application of blink reflex combined with brain stem auditory evoked potential examinations in diagnosis of posterior-circulation ischemia

目的 探讨瞬目反射（BR）联合脑干听觉诱发电位（BAEP）检查在后循环缺血（PCI）诊断中的应用价值。方法选取71例PCI患者为PCI组,包括后循环短暂性脑缺血发作（TIA）48例和后循环梗死23例。另选取同期健康体检者40例为对照组。2组均行BR和BAEP检查,对比2组相关电生理指标。结果 1 PCI组中,53例（74.6%）BR检测异常,后循环TIA和后循环梗死患者R1、R2、R2＇波潜伏期均显著长于对照组（P〈0.01）,但两者间各波潜伏期差异无统计学意义（P〉0.05）。2 PCI组中,50例（70.4%）BAEP异常,后循环TIA和后循环梗死患者Ⅰ、Ⅲ、Ⅴ波PL和Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波IPL均较对照组显著延长（P〈0.01）,但两者间差异无统计学意义（P〉0.05）。3联合检测异常61例（85.9%）,高于BR或BAEP单独检测,但差异无统计学意义（P〉0.05）。结论 BR和BAEP均能反映PCI患者脑干供血情况,两者联合检测对PCI早期诊断和脑损伤区定位有重要的参考价值。

Objective To explore the application value of blink reflex（BR） combined with brain stem auditory evoked potential（BAEP） examinations in diagnosis of posterior-circulation ischemia（PCI）. Methods A total of 71 patients with PCI served as PCI group, including 48 cases with posterior-circulation transient iscbemic attack （TIA） and 23 cases with posterior-circulation infarction. Another 40 healthy people undergoing physical examination served as control group. BR and BAEP examinations were conducted in both groups and corresponding electrophysiological indexes were compared between two groups. Results ① In PCI group, 53 （74.6%） patients had abnormal BR detection, and the periods of latency （PL） of R1, R2 and R3 waves in patients with posterior-circulation TIA and infarction were markedly longer than those in control group （ P 〈 0.01 ） , but there was no significant difference between patients with posterior-circulation TIA and infarction （P 〉 0.05）. ② In PCI group, 50 （70.4%） patients had abnormal BAEP detection, the PL of I , III and V waves as well as interpeak latency （IPL） of I - III, III- V and I - Vwaves in patients with posterior-circulation TIA and infarction were notably longer than those in control group （P 〈0.01 ） , but there was no significant difference between patients with posterior-circulation TIA and infarction （ P 〉 0.05 ）. ③ A total of 61 （ 85.9% ） patients had normal combined examinations, which was higher than the single examination of BR or BAEP, but the differences were not significant （P 〉 0.05）. Conclusion Both BR and BAEP can reflect the brain stem blood-supply conditions of PCI patienfs, and their combined detection has important reference value in the early diagnosis of PCI and location of brain damage area.