缺血缺氧性脑病患儿视觉发育障碍的早期视诱发电位评估

Early evaluation of visual evoked potential in hypoxic ischemic encephalopathy children with visual developmental disorders

目的:探讨早期视诱发电位(VEP)检测对缺氧缺血性脑病(HIE)患儿的临床价值。方法:选取HIE患儿100例为研究对象,依据HIE临床分度标准分为HIE轻度组37例、中度组38例和重度组25例;另选取同期健康幼儿30名为对照组。比较各组闪光诱发电位(F-VEP)和图形诱发电位(P-VEP)的潜伏期和波幅,并比较HIE各组患儿斜视、眼球振颤、视神经萎缩等眼部功能异常的发生率。结果:HIE各组患儿F-VEP和P-VEP振幅均明显低于对照组(P<0.01),且随着患儿HIE病情程度增加而降低(P<0.01);HIE各组患儿潜伏期均高于对照组(P<0.01),且随着患儿病情程度增加而增加(P<0.01)。各组HIE患儿斜视、眼球震颤、视神经萎缩发生率和眼部病变总发生率差异均有统计学意义(P<0.05~P<0.01)。结论:早期VEP检测可用于评估HIE患儿早期视觉发育障碍情况,对新生儿HIE的早期诊断、病情评估及指导治疗具有重要意义。

Objective:To explore the clinical value of early visual evoked potential(VEP)detection in children with hypoxic ischemic encephalopathy(HIE).Methods:One hundred children with HIE were divided into the mild group(37 cases),moderate group(38 cases)and severe group(25 cases)according to the clinical classification standard of HIE,and 30 healthy infants in the same period were set as the control group.The latency and amplitude of flash evoked potential(F-VEP)and pattern evoked potential(P-VEP)were compared among four groups.The incidence rates of strabismus,eye flutter and optic nerve atrophy of eye function abnormalities were compared among three groups of HIE patients.Results:The amplitude of F-VEP and P-VEP in three groups of HIE patients were significantly lower than those in control group(P<0.01),and which decreased with the increasing of HIE degree(P<0.01).The latency in three groups of HIE patients were higher than that in control group(P<0.01),and which increased with the increasing of HIE degree(P<0.01).The differences of the incidence rates of strabismus,nystagmus,optic nerve atrophy and total incidence rate of ocular lesions among three groups of HIE patients were statistically significant(P<0.05 to P<0.01).Conclusions:Early VEP detection can accurately evaluate the degree of brain injury and visual impairment of HIE neonates,which is of great significance for early diagnosis,disease evaluation and treatment guidance of HIE neonates.