CAJ | 학술논문

目的观察实验性急性脊髓损伤过程中体感诱发电位(SEP)及经颅磁刺激运动诱发电位(TMS-MEP)的变化规律,探讨其应用价值.方法将日本大耳兔32只随机分为4组,每组8只.A组为对照组,B、C、D组分别为轻、中、重度脊髓损伤组(脊髓压迫时间分别为5、15、30 min).于麻醉后,暴露脊髓后,伤后5、30 min、1、6、24 h和3、7 d分别检测各组动物SEP、MEP,对所得波形数据进行统计学分析.于伤后1、3、7 d采用后肢的Tarlov分级行运动功能评分.结果刺激强度是影响TMS-MEP稳定性的一个比较重要的因素,100%刺激强度可获得稳定的波形.随着脊髓压迫时间的延长,SEP、MEP的潜伏期逐渐延长,波幅逐渐减小,波幅变化比潜伏期变化更加灵敏.在脊髓恢复过程中,潜伏期恢复早于波幅,SEP恢复早于MEP.结论 SEP与TMS-MEP对脊髓损伤十分敏感,二者结合能客观地反映脊髓损伤程度.
목적 관찰실험성급성척수손상과정중체감유발전위(SEP)급경로자자격운동유발전위(TMS-MEP)적변화규률,탐토기응용개치.방법 장일본대이토32지수궤분위4조,매조8지.A조위대조조,B、C、D조분별위경、중、중도척수손상조(척수압박시간분별위5、15、30 min).우마취후,폭로척수후,상후5、30 min、1、6、24 h화3、7 d분별검측각조동물SEP、MEP,대소득파형수거진행통계학분석.우상후1、3、7 d채용후지적Tarlov분급행운동공능평분.결과 자격강도시영향TMS-MEP은정성적일개비교중요적인소,100%자격강도가획득은정적파형.수착척수압박시간적연장,SEP、MEP적잠복기축점연장,파폭축점감소,파폭변화비잠복기변화경가령민.재척수회복과정중,잠복기회복조우파폭,SEP회복조우MEP.결론 SEP여TMS-MEP대척수손상십분민감,이자결합능객관지반영척수손상정도.
Objective To study the changes of somatosensory evoked potential(SEP)and transcranial magnetic simulation motor evoked potential(TMS-MEP)in experimental spinal cord injury (SCI).Methods Thirty-two rabbits were randomly divided into 4 equal groups.All rabbits were anesthetized for 90 min.A grouP(Group A) underwent only laminectomy of T12 without SCI,stimulation with difrerent intensities was used to induce SEP and TMS-MEP to determine the most appropriate stimulation intensity.The EPs were recorded before and after the operation.The other 3 groups underwent laminectomy of T12 to expose the dura,and a spinal cord compressing apparatus weighing 40 g was put on the intact dura and dorsal surface 0f spinal cord underneath for 5,15,and 30 rain respectively(Groups B,C,and D).SEP and TMS-MEP were detected after anesthesia,after exposure of spinal cord,and 5 and 30 min,1 and 6h,and 1,3,and 7 d.The latency and amplitude of each wave were measured.The data were analyzed by analysis of variance,t-test and linear correlation.Tarlov behavior score was used to assess the motor function before the operation and 1,3,and 7 days after SCI.Results It was found that 100% intensity stimulus obtained stable and reliable MEP waves.Anesthetic did not influence the EPs.The amplitude of SEP began to decrease 5 min after SCI and the latency began to increase 30 min after SCI.And both the amplitude and latencv,especially the former,of MEP began to significantly change 5 min after SCI.The latency levels of SEP and MEP increased and the amplitude decreased after compression time-dependently during a certain range of time(all P＜0.05).The latency of SEP recovered 1 d after SCI and the amplitude recovered 7 d after:and the latency of MEP recovered 3 d after SCI and the amplitude did not recover even 7 d after SCI.The Tarlov scores of all groups were all 5 before operation,and the Tarlov scores of Group C and D became 1 d after operation and then increased later,however,still lower than 5 even at day 7.Conclusion SEP and TMS-MEP are very sensitive to SCI,in particular,the change of amplitude is more sensitive then the latency change and can more accararely reflect the degree of SCI.Combination of SEP and TMS-MEP objectively reflects the SCI degree.EP measurement,as a noninvasive technique,has great value in monitoring spinal cord function.