F波及瞬目反射对急性周围性面瘫的评估价值

Evaluation value of F wave and blink reflex in acute peripheral facial paralysis

目的:评价瞬目反射(BR)、面神经F波对急性周围性面瘫患者面神经损害的早期诊断以及预后评估价值。方法:选取2020年4月至2022年1月于南京医科大学附属无锡人民医院确诊并接受治疗的45例单侧发病的急性周围性面瘫患者作为面瘫组,同时选择45例健康人作为对照组。对照组测定双侧面神经F波及BR,而面瘫组分别于发病第7天(治疗前)与第30天(治疗后)进行双侧面神经F波及BR检测。比较两组F波出波率、最短潜伏期及BR潜伏期。结果:患侧F波及BR在疾病早期均出现异常。治疗前,面瘫组患侧F波潜伏期较健侧及对照组均延长,出波率较健侧及对照组均明显减少(P均<0.001);治疗后,患侧F波潜伏期仍较健侧及对照组延长,出波率降低,但患侧F波出波率较治疗前增高,差异均具有统计学意义(P<0.001)。面瘫组治疗前,患侧R1、R2及健侧R2'较健侧R1、R2及患侧R2'潜伏期延长,并且较对照组双侧R1、R2、R2'潜伏期均延长(P<0.001);治疗后患侧R1潜伏期较治疗前明显缩短(P<0.05),患侧R1、R2及健侧R2'仍较对照组双侧R1、R2、R2'潜伏期延长(P<0.001)。结论:F波及BR检测在周围性面瘫的早期诊断方面具有较高的敏感性,治疗后面瘫患者患侧的F波及BR与健侧及正常人群比较仍存在差异,对周围性面瘫患者的预后具有一定的评估价值。

Objective:To explore the early diagnosis and prognostic value of blink reflex(BR)and F wave of facial nerve in patients with acute peripheral facial paralysis.Methods:Forty-five patients with unilateral acute peripheral facial paralysis diagnosed and treated in the Affiliated Wuxi People's Hospital of Nanjing Medical University from April 2020 to January 2022 were enrolled as the facial paralysis group,and 45 healthy subjects were enrolled as the control group.F wave and BR of bilateral facial nerve were measured in the control group,and which were detected at the 7th day(before the treatment)and 30th day(after the treatment)respectively in the facial paralysis group.The occurrence rate of F wave and minimum latency,and latency of BR were compared between the two groups.Results:Both F wave and BR were abnormal at earlier diagnosis.Before the treatment,the latency of F wave of the affected side in the facial paralysis group was longer than that of the healthy side and the control group,and the occurrence rate of F wave was significantly lower than that of the healthy side and the control group(P<0.001).After the treatment,the latency of F wave of the affected side was still longer than that of the healthy side and the control group,and the occurrence rate of F wave was lower.However,the occurrence rate of F wave of the affected side was higher than that before the treatment(P<0.001).The outcome of BR were roughly the same.In the facial paralysis group,the latency of R1,R2 of the affected side and R2'of the healthy side was longer than that of R1,R2 of the healthy side and R2'of the affected side before the treatment,and longer than that of R1,R2 and R2'of both sides in the control group(P<0.001).After the treatment,the latency of R1 of the affected side was significantly shorter than that before the treatment(P<0.05),and the latency of R1,R2 of the affected side and R2'of the healthy side were still longer than that of R1,R2 and R2'of both sides in the control group(P<0.001).Conclusions:F wave and BR have high sensitivity at earlier diagnosis of acute peripheral facial paralysis.After the treatment,the F wave and BR of the affected side of patients with facial paralysis is still different from that of the healthy side and the normal population,which has a certain evaluation value for the prognosis of patients with peripheral facial paralysis.