肝硬化患者视觉和体感诱发电位的研究

Study of Visual and Somatosensory Evoked Potentials in the Patients with Liver Cirrhosis

对 30例临床无明显肝性脑病的非酒精性肝硬化患者和 30例正常对照进行了视觉诱发电位 (VEP)和短潜时体感诱发电位 (SSEP)检查。结果显示 ,肝硬化组VEP和SSEP各波潜伏期及SSEP的N13～N2 0、N13～P2 5峰间期均比对照组明显延长 ,肝硬化组VEP的P10 0、N12 5波幅明显低于对照组。肝硬化组VEP、SSEP的异常率分别是 36 .7%、6 0 %,有 1种或 2种诱发电位异常的患者占 76 .7%。以上结果表明肝硬化患者在临床发生肝性脑病之前 ,已经有脑诱发电位异常和脑功能损害。脑诱发电位能敏感、客观地早期诊断肝硬化患者的亚临床性肝性脑病 ,其中SSEP最敏感。

Visual evoked potentials(VEP) and short latency somatosensory evoked potentials(SSEP) were examined in 30 nonalcoholic liver cirrhotics without clinically detectable hepatic encephalopathy and 30 control subjects.The results showed that all peak latencies of the two kinds of evoked potentials and the interpeak latencies of N13～N20,N13～P25 of SSEP were significantly prolonged than those of the controls.The two kinds of evoked potentials were abnormal in 76.7% of the cirrhotic patients.The VEP and SSEP were abnormal in 36.7% and 60% of the cirrhotic patients,respectively.It is concluded that the cirrhotic patients, before the appearance of clinically encephalopathy,there are already brain evoked potential abnormalities or brain function changes.It is suggested that the brain-evoked potentials is an important examination for the sensitive and objective diagnosis of subclinical hepatic encephalopathy in patients with nonalcoholic cirrhosis and SSEP is the most sensitive one.