目的 观察瞬目反射(BR)和脑干听觉诱发电位(BAEP)在意识障碍患者中的变化特征,探讨其对意识障碍患者脑干功能的评估作用。方法 2015年1月至12月,31例意识障碍患者行BR、BAEP检查,同时进行Glasgow昏迷量表(GCS)评分。1个月后进行预后判断。结果 BAEP、BR分级与GCS评分均呈正相关(r≥0.562, P<0.05)。BAEP、BR各级预后有非常显著性差异(χ2=9.644, P<0.01)。结论 BAEP、BR检查方便易行,能敏感地反映脑干功能,并能反映脑干不同传导通路,两者联合检查能更加客观地为预后评定提供可靠的依据。
Objective To explore the characteristics of blink reflex (BR) and brainstem auditory evoked potential (BAEP) in patients with consciousness disorder and the role of BR and BAEP in the evaluation of brain stem function.Methods From January to December, 2015, 31 patients with consciousness disorder were examined with BAEP, BR and Glasgow Coma Scale (GCS), and the outcome was recorded one month after examination.Results BAEP and BR were positively related with GCS score (r≥0.562, P<0.05) and outcome (χ2=9.644, P<0.01).Conclusion Both BR and BAEP can reflect the brain stem function and respective pathway. Their combination could provide Objective basis for prognosis evaluation.
[1] Covelli V, Sattin D, Giovannetti AM, et al. Caregiver's burden in disorders of consciousness: a longitudinal study [J]. Acta Neurol Scand, 2016, 134(5): 352-359.
[2] Reith FC, Synnot A, van den Brande R, et al. Factors influencing the reliability of the Glasgow Coma Scale: a systematic review [J]. Neurosurgery, 2017, 80(6): 829-839.
[3] 肖淑英,宿英英,张艳,等. 诱发电位预测重症脑卒中患者不良预后时机研究[J]. 中国现代神经疾病杂志, 2015, 15(12): 944-949.
[4] 卢祖能. 实用肌电图学[M]. 北京:人民卫生出版社, 2000: 339-343.
[5] 张艳,宿英英. 脑干听觉诱发电位分级标准评价脑功能损伤的研究[J]. 中国急救医学, 2003, 23(9): 623-624.
[6] Reith FC, van den Brande R, Synnot A, et al. The reliability of the Glasgow Coma Scale: a systematic review [J]. Intensive Care Med, 2016, 42(1): 3-15.
[7] Chastain CA, Oyoyo UE, Zipperman M, et al. Predicting outcomes of traumatic brain injury by imaging modality and injury distribution [J]. J Neurotrauma, 2009, 26(8): 1183-1196.
[8] Ganes T, Lundar T. EEG and evoked potentials in comatose patients with severe brain damage [J]. Electroencephalogr Clin Neurophysiol, 1988, 69(1): 6-13.
[9] Su YY, Xiao SY, Haupt WF, et al. Parameters and grading of evoked potentials: prediction of unfavorable outcome in patients with severe stroke [J]. J Clin Neurophysiol, 2010, 27(1): 25-29.
[10] Liesien R, Kevalas R, Uloziene I, et al. Search for clinical and neurophysiological prognostic patterns of brain coma outcomes in children [J]. Medicina (Kaunas), 2008, 44(4): 273-279.
[11] Mabin D, Mimassi N, Besson G, et al. [Prognostic value of the trigemino-facial reflex in severe post-traumatic comas] [J]. [in French]. Rev Electroencephalogr Neurophysiol Clin, 1982, 12(4): 349-356.
