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学科主题: 神经病学
题名:
亚急性联合变性病上肢的躯体感觉诱发电位特点
其他题名: The study of somatosensory evoked potential of the upper limbs in subacute combined degeneration
作者: 王亭亭1; 贾志荣1; 潘涛1; 柳竹1; 石昕1; 梁为1
关键词: 脊髓亚急性联合变性 ; 电生理学 ; 诱发电位,躯体感觉 ; 上肢 ; Subacute combined degeneration ; Electrophysiology ; Evoked potentials,somatosensory ; Upper extremity
刊名: 中华神经科杂志
发表日期: 2013
DOI: 10.3760/cma.j.issn.1006-7876.2013.05.006
卷: 46, 期:5, 页:308-312
收录类别: 中国科技核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 分析亚急性联合变性(subacute combined degeneration,SCD)的躯体感觉诱发电位(somatosensory evoked potential,SEP)上肢各波潜伏期及各波峰间期改变特点,探讨SCD的上肢SEP特点及上肢SEP对SCD中枢病变的诊断价值.方法 回顾性分析34例临床确诊的SCD患者临床资料、躯体感觉诱发电位、脊髓MRI的检查结果并观察其特点.对比SCD组与健康对照组的SEP各波潜伏期的差异,将SCD组的SEP结果按照周围段及中枢段进行分析.结果 与健康对照组相比,SCD组上肢N9[(10.80±1.07) ms与(10.23 ±0.64) ms,t=3.223]、P14[17.28±2.56) ms与(14.62 ±0.84) ms,t =6.643]、N9 ~ P14[(6.48 ±2.27) ms与(4.40 ±0.58) ms,t =5.951]及下肢N9[(12.11 ±0.83) ms与(10.93 ±0.56) ms,=5.690]、P30[(36.96 ±5.56) ms与(30.37±2.20)ms,t=7,217]及P38[(46.94 ±5.83) ms与(39.80±2.54) ms,t =7.353]各潜伏期均较健康对照组延长,差异均具有统计学意义(均P <0.01).SCD组P14 ~ N20间期较健康对照组延长,差异无统计学意义.SCD组SEP异常率为80.9%(110/136),上肢异常率为85.3%(58/68),下肢异常率为76.5%(52/68).上肢N9 ~ P14间期异常率最高,为72.1% (49/68).在N9正常的神经中,中枢传导时间中N9 ~ P14节段的异常率(64.9%,24/37)最高.SCD组N9正常的神经和健康对照组比较,N9 ~ P14延长,差异具有统计学意义[(5.98±1.90) ms与(4.40 ±0.58) ms,t=5.267,P<0.01].结论 SCD不仅可累及感觉神经周围段传导通路,还可累及脑干和大脑半球的中枢段感觉神经传导通路.在SCD患者上肢SEP中,N9 ~ P14异常率较高,中枢病变以颈髓到脑干的感觉传导通路受损更明显.SEP上肢中枢传导时间的测定,可提供SCD中枢受损的客观依据. Objective To analyze the features of the latency and interval in somatosensory evoked potentials (SEP) of the upper limbs in subacute combined degeneration(SCD),and evaluate the SEP of the upper limbs in the diagnosis of SCD.Methods Thirty-four defined SCD patients and 22 healthy controls were included in this study.The patients underwent the SEP test and the magnetic resonance imaging(MRI)of spinal cord.The SEP results of the patients were compared with those of the controls.The results of the SEP,which were divided into the peripheral part and central part to be evaluated,were also compared with the related results of the SEP and MRI.Results Compared with the controls,the N9 ((10.80 ± 1.07) ms vs (10.23 ± 0.64) ms,t =3.223),P14 ((17.28 ± 2.56) ms vs (14.62 ± 0.84) ms,t =6.643),N9-P14 ((6.48±2.27) ms vs(4.40-0.58) ms,t =5.951) in the upper limbs and N9((12.11 ±0.83) ms vs (10.93±0.56) ms,t=5.690),P30((36.96±5.56) ms vs(30.37±2.20) ms,t=7.217),P38 ((46.94 ±5.83) ms vs(39.80 ±2.54) ms,t =7.353) in the lower limbs of SCD patients were prolonged (all P <0.01),however,the P14-N20 was prolonged without statistical significance.The abnormality of SEP was 80.9% (110/136),in which the abnormality of the upper limbs was 85.3% (58/68)while that of the lower limbs was 76.5% (52/68).N9-P14 had the highest abnormality rate which was 72.1% (49/68).The patients with SCD with normal N9 had prolonged N9-P14 ((5.98 ± 1.90) ms vs(4.40 ± 0.58) ms,t =5.267,P < 0.01).Conclusions Subacute combined degeneration can involve not only the peripheral part of the somatosensory pathway but also the central part including the brainstem and brain.In the SEP of upper limbs,N9-P14 has the highest abnormality rate which suggests that the part from cervical spinal cord to the brainstem may be the most vulnerable in SCD.The test of SEP in the upper limbs may provide evidence for the damage in the central part in SCD.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/41281
Appears in Collections:北京大学第一临床医学院_神经内科_期刊论文

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作者单位: 1.100034,北京大学第一医院神经科
2.深圳卓正医疗投资有限公司
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