CAJ | 학술논문

目的通过分析脑干梗死患者眼前庭诱发肌源性电位(oVEMP)的电生理特点,并与脑干听觉诱发电位(BAEP)进行对比研究,探讨oVEMP对脑干梗死患者的临床应用价值.方法对60例脑干梗死患者(纳入脑干梗死组)分别进行oVEMP和BAEP检测,并将其结果与60例健康志愿者(纳入正常对照组)数据进行对照.结果正常对照组60例健康志愿者中有2例未引出oVEMP,其余58例健康志愿者均引出可辨析、稳定的N1-P1波形,引出率为96.7％.脑干梗死组共有42例患者引出oVEMP,其双侧N1、P1峰潜伏期均较正常对照组显著延长(P＜0.05),双侧N1-P1波幅均较正常对照组明显降低(P＜0.05);有18例患者未引出oVEMP,其中N1波峰潜伏期延长13例,P1峰潜伏期延长10例,同时出现N1、P1峰潜伏期延长6例,N1-P1波幅降低8例,共计oVEMP异常45例,异常率为75％.脑干梗死组BAEP的Ⅴ波潜伏期[(5.98±0.37)ms]及Ⅲ～Ⅴ波、Ⅰ～Ⅴ波峰间潜伏期[分别为(2.93±0.34) ms和(4.96±0.39) ms]均较正常对照组显著延长,Ⅴ/Ⅰ波幅比值(0.48±0.10)较正常对照组显著降低(P＜0.05);其中Ⅴ波潜伏期延长17例,Ⅲ波潜伏期延长6例,Ⅲ～Ⅴ波峰间潜伏期延长15例,Ⅰ～Ⅴ波峰间潜伏期延长9例,11例Ⅲ-Ⅴ/Ⅰ-Ⅲ峰间潜伏期比值＞1,13例Ⅴ/Ⅰ波幅比值＜0.5,3例波形分化不良,共计BAEP异常42例,其异常率为70％.oVEMP异常率与BAEP异常率间差异无统计学意义(P＞0.05).联用oVEMP与BAEP的检测异常率为91.7％,明显高于BAEP异常率(P＜0.05).结论 oVEMP是检测脑干梗死的可靠电生理方法,与BAEP联用能进一步提高脑干梗死患者的病灶检出率.
목적 통과분석뇌간경사환자안전정유발기원성전위(oVEMP)적전생리특점,병여뇌간은각유발전위(BAEP)진행대비연구,탐토oVEMP대뇌간경사환자적림상응용개치.방법 대60례뇌간경사환자(납입뇌간경사조)분별진행oVEMP화BAEP검측,병장기결과여60례건강지원자(납입정상대조조)수거진행대조.결과 정상대조조60례건강지원자중유2례미인출oVEMP,기여58례건강지원자균인출가변석、은정적N1-P1파형,인출솔위96.7％.뇌간경사조공유42례환자인출oVEMP,기쌍측N1、P1봉잠복기균교정상대조조현저연장(P＜0.05),쌍측N1-P1파폭균교정상대조조명현강저(P＜0.05);유18례환자미인출oVEMP,기중N1파봉잠복기연장13례,P1봉잠복기연장10례,동시출현N1、P1봉잠복기연장6례,N1-P1파폭강저8례,공계oVEMP이상45례,이상솔위75％.뇌간경사조BAEP적Ⅴ파잠복기[(5.98±0.37)ms]급Ⅲ～Ⅴ파、Ⅰ～Ⅴ파봉간잠복기[분별위(2.93±0.34) ms화(4.96±0.39) ms]균교정상대조조현저연장,Ⅴ/Ⅰ파폭비치(0.48±0.10)교정상대조조현저강저(P＜0.05);기중Ⅴ파잠복기연장17례,Ⅲ파잠복기연장6례,Ⅲ～Ⅴ파봉간잠복기연장15례,Ⅰ～Ⅴ파봉간잠복기연장9례,11례Ⅲ-Ⅴ/Ⅰ-Ⅲ봉간잠복기비치＞1,13례Ⅴ/Ⅰ파폭비치＜0.5,3례파형분화불량,공계BAEP이상42례,기이상솔위70％.oVEMP이상솔여BAEP이상솔간차이무통계학의의(P＞0.05).련용oVEMP여BAEP적검측이상솔위91.7％,명현고우BAEP이상솔(P＜0.05).결론 oVEMP시검측뇌간경사적가고전생리방법,여BAEP련용능진일보제고뇌간경사환자적병조검출솔.
Objective To explore the value of ocular vestibular evoked myogenic potential in treating brainstem infarctions through comparing the characteristics ocular vestibular evoked myogenic potential (oVEMP) and brainstem auditory evoked potential (BAEP) in patients with brainstem infarctions.Methods A total of 60 patients with brainstem infarctions were enrolled in a brainstem infarction (BI) group, while another sixty healthy volunteers were selected as the control group.All patients underwent oVEMP and BAEP tests via air-conducted stimuli.Results The oVEMPs were elicited reliably and stably in 58 of the control group, and 42 of the BI group, with the bilateral N1 and P1 latencies of oVEMP significantly prolonged [N1 (left) : 11.85 ± 0.82 ms, N1 (right) : 11.91 ± 0.86 ms, P1 (left) : 15.52 ± 1.61 ms, P1 (right) : 15.63 ± 1.64 ms respectively] and the bilateral N1-P1 amplitudes of oVEMP significantly reduced [1.23 ±0.42 μV (left) and 1.58 ± 0.70 μV (right) respectively].Moreover, no recordable oVEMPs was elicited in the other 18 patients, among which found 13 prolonged N1 latencies, 10 prolonged P1 latencies, 6 prolonged N1 and P1 latencies and 8 reduced N1-P1 amplitudes of oVEMP.Altogether, 45 abnormal oVEMPs were found, with an abnormal rate of 75％.The average peak latencies of Ⅴ waves [(5.98 ± 0.37) ms] and interpeak latencies of Ⅲ-Ⅴ and Ⅰ-Ⅴ waves [2.93 ± 0.34 ms and 4.96 ± 0.39 ms respectively] in the BI group were significantly prolonged compared to the controls (P＜ 0.01).The amplitude ratio of Ⅴ/Ⅰ (0.48 ± 0.10) in the BI group was significantly reduced compared to the controls (P ＜ 0.05).Forty-two abnormal BAEPs were found, with an abnormal rate of 75％ , including 17 prolonged latency of Ⅴ waves, 6 prolonged latency of Ⅲ waves, 15 prolonged interpeak latencies of Ⅲ-Ⅴ waves, 9 prolonged interpeak latencies of Ⅰ-Ⅴ waves, 11 cases of Ⅲ-Ⅴ interpeak latency larger than Ⅰ-Ⅲ interpeak latencies, 13 cases of the amplitude ratio of Ⅴ / Ⅰ smaller than 0.5 and 3 case of unclear waves.There were no significant differences in abnormal rate when using the oVEMP (42/60 and 75％) and BAEP (45/60 and 70％) testing However, the abnormal rate was 91.7％ when combining oVEMP with BAEP testing, significantly higher than that when only conducting BAEP testing.Conclusion Patients with brainstem infarctions have abnormalities in oVEMP.Combined with MRI and other electrophysiological testing, oVEMP may contribute to the diagnosis of brainstem infarctions.