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目的:探讨诱发电位结合神经传导速度检查的结果在脊髓亚急性联合变性患者诊断中的临床价值。方法:回顾性分析余姚市人民医院2010年1月—2016年10月接诊的30例脊髓亚急性联合变性患者的资料,统计患者进行的磁共振检查(MRI)、诱发电位(体感诱发电位、脑干听觉诱发电位、视觉诱发电位)、神经传导速度检查的结果、血清维生素B12水平和症状等,将诱发电位结合神经传导速度检查的结果与磁共振检查进行分析比较,分析其在脊髓亚急性联合变性患者诊断中的临床价值。结果:所有患者均经过诱发电位结合神经传导速度检查的结果与MRI检查,两种不同的方法相比,其中诱发电位结合神经传导速度检查的结果显示异常率为83.33%,MRI检查的异常率为53.33%,诱发电位结合神经传导速度检出的异常率明显高于MRI,有统计学意义(χ~2=6.238 8,P=0.012 5);21例患者P40,潜伏期延长(48.65±1.85)ms,或波幅降低(1.95±1.22)μV,12例深感觉障碍者均显示P40波幅降低;BAEP1例左侧Ⅲ波和Ⅴ波峰潜伏时延长,2例右耳Ⅲ-Ⅴ波波间期延长,2例左耳Ⅴ波峰潜伏期延长并且Ⅰ-Ⅲ波间期小于Ⅲ-Ⅴ波间期;VEP有6例P100潜伏期延长,伴或不伴有波幅降低;13例患者神经传导速度检查显示神经传导速度减慢或感觉神经SNAP波幅降低。结论:诱发电位结合神经传导速度检查的结果,能客观反映脊髓亚急性联合变性病变的部位,协助脊髓亚急性联合变性定位诊断,其检查的异常率高较高,临床价值较高,值得推广应用。
Objective: To investigate the clinical value of evoked potential combined with nerve conduction velocity in the diagnosis of patients with subacute combined degeneration of spinal cord. Methods: The data of 30 patients with spinal cord subacute combined degeneration admitted from January 2010 to October 2016 in Yuyao People’s Hospital were retrospectively analyzed. The MRI, evoked potential (somatosensory evoked potential, Brainstem auditory evoked potential, visual evoked potential), nerve conduction velocity test results, serum vitamin B12 levels and symptoms, the evoked potential combined with nerve conduction velocity test results were compared with magnetic resonance imaging, analysis of its spinal cord subacute Clinical value of combined degeneration patients. Results: Compared with MRI, all patients had evoked potentials combined with nerve conduction velocity test. Compared with two different methods, the evoked potential combined with nerve conduction velocity test showed that the abnormality rate was 83.33%. The abnormal rate of MRI examination was 53.33%. The abnormal rate of evoked potentials combined with nerve conduction velocity was significantly higher than that of MRI (χ ~ 2 = 6.238 8, P = 0.012 5). The P40 of 21 patients prolonged (48.65 ± 1.85) ms , Or amplitude decreased (1.95 ± 1.22) μV, 12 cases of deep sensory disturbances showed P40 amplitude decreased; BAEP1 cases left Ⅲ wave and Ⅴ peak latency, 2 cases of right ear Ⅲ-Ⅴ wave interval prolongation, 2 Cases of left ear Ⅴ peak latency and Ⅰ-Ⅲ wave interval less than Ⅲ-Ⅴ wave interval; VEP 6 cases of P100 latency was prolonged with or without amplitude decrease; 13 patients with nerve conduction velocity examination showed nerve conduction velocity decreased Slow or sensory nerve SNAP amplitude decreases. Conclusion: The result of evoked potential combined with nerve conduction velocity test can objectively reflect the location of subacute combined degeneration of spinal cord and assist the diagnosis of subacute combined degeneration of spinal cord. The abnormal rate of examination is high and the clinical value is high, which is worthy of popularization and application .