服用苯妥英钠过量患者平衡功能障碍的定量分析

Postural balance dysfunction in patients with phenytoin poisoning,a quantitative study

目的定量分析服用苯妥英钠过量患者的平衡功能,了解其发生平衡功能障碍的机制及参数变化。方法采用人体重心平衡仪(AnimEAB-100),测试了60例健康自愿者和24例苯妥英钠中毒患者的重心摆动轨迹图。结果服用苯妥英钠过量的患者重心摆动轨迹呈弥散型摆动面积增大,摆动中心前后方向移动增大,单位面积轨迹长缩短,与健康自愿者比较差异有显著性意义。重心平衡障碍方式可分为中间型4例,弥散型11例,多中心型7例,前后型2例。结论重心平衡检查可定量分析苯妥英钠中毒患者的平衡功能状态,对平衡障碍的程度及今后的康复干预提供客观的判定参数。

Aim To discover a quantitatively measur able parameter in the study of static equilibrium in patie nts taking overdose phenytoin.Methods Twenty-four patients with epilepsy,16males and 8females,aged 14-47,were given phenytoin in the dose of 1.35g /d for 2-20days till dysequilibr ium occurred.Then the patients were ask ed to stand on the plant stabilometer for 1minute with the eyes opened and close d respectively so as to record the pat tern of postural sway path length per seco nd(PATH),average radial displacement (ARD),and mean frequency of sway(Freq),and circumference area(CA).Sixty sex and age-matched healthy volunteers were used as controls.Results The locus of postural sway in epilepi c patients with overdose phenytoin was of diffuse pattern.The sway area and di splacement of the center of gravity were increased.Unit area path length was shortened.With the eyes opened,Pat h was(16±7)mm /s in the epilepsy patients and(11±3)mm /s in the controls(P<0.05);with the eyes closed,PATH was(18±9)mm /s in the epilepsy patients and(14±5)mm /s in the controls(P<0.05).With the eyes opened,ARD was(9.4±3.1)mm in the epilepsy patients and(4.9±1.5)mm in the controls(P<0.05);with the eyes closed,ARD was(9.2±5.1)mm in the epilepsy patients and(3.8±2.7)mm in the controls(P<0.05).With the eyes opened,Freq was(0.32±0.08)HZ in the epilepsy patients and(0.36±0.08)Hz in the controls(P<0.05);with the eyes closed Freq was(0.35±0.10)Hz and(0.43±0.08)Hz (P<0.05).With eyes opened CA was(50±61)mm 2 /s in the epilepsy patients and(16±13)mm 2 /s in the controls(P<0.05);with the eyes closed CA was(79±85)mm 2 /s in the patients and(29±28)mm 2 /s in the controls.Conclusion Objective param-eters obtained in balance examination of the center of gravity can be used to quantitatively analyze the balance function of patients of overdose phenytoin