体感诱发电位、脑干听觉诱发电位和P300检测对持续植物状态患者预后判定的应用价值

Detective value of SEP,BAEP and P300 in predicting the prognosis of patients with persistent vegetative state

目的探讨体感诱发电位(somatosensory evoked potential,SEP)、脑干听觉诱发电位(brainstem auditory evoked potentials,BAEP)、事件相关电位P300检测对持续植物状态(persistent vegetative state,PVS)患者预后判定的作用.方法采用前瞻性队列研究,对PVS患者进行SEP、BAEP、P300检测,并分析其与格拉斯哥昏迷量表(GCS)评分的关系.结果35例PVS患者预后不良组P300波潜伏期[(424.00±51.39)ms]较预后良好组[(374.00±67.92)ms]明显延长,差异有统计学意义(P<0.05),预后不良组与预后良好组患者P300波振幅无明显差异(P>0.05),N20的存在与消失(单侧或双侧)、波幅及潜伏期在预后不良及预后良好组之间差异无统计学意义(P>0.05),35例患者听觉诱发电位均中重度异常,听觉诱发电位分级与预后的关系差异无统计学意义(P>0.05).结论P300潜伏期可作为预测PVS患者预后的指标.

Objective To investigate the effects of somatosensory evoked potential(SEP),brainstem auditory evoked potential(BAEP)and event-related potential(P300)on the prognosis of patients with persistent vegetative state(PVS).Methods SEP,BAEP,and P300 were detected in PVS patients and the relationship with the Glasgow Coma Scale(GCS)was analyzed in the study.Results Study results of the 35 cases with PVS showed that the latency of P300 in the poor prognosis group(424.00±51.39 ms)was significantly longer than that(374.00±67.92 ms)in the good prognosis group,and statistical significance could be seen,when comparisons were made between them(P<0.05).There was no significant difference in the amplitude of P300 between the poor and good prognosis groups(P<0.05).There was no statistical significance between the poor and good prognosis groups in the presence and absence of N20(one side or both sides),and statistical significance could neither be seen in the amplitude and latency,when comparisons were made between the poor and good prognosis groups(P<0.05).The BAEP of the 35 patients all showed moderate to severe abnormality,but there was no statistical significance in the relationship between BAEP grades and prognosis(P<0.05).Conclusion P300 latency could be used as an indicator in the prediction of prognosis for those patients with persistent vegetative state.