【摘要】 目的:探讨神经电生理检查在亚急性联合变性(SCD)早期诊断及疾病预后判定中的意义。方法:选取35例SCD患者,分别进行脊髓MRI、胫后神经体感诱发电位(SEP)、正中神经SEP、视觉诱发电位(VEP)和神经传导速度(NCV)检查,比较上述检查阳性率的差异,探讨不同检查的诊断敏感性及其对应神经结构受累的时序差别。结果:本组30例SCD患者接受脊髓MRI检查,其中有12例(40%)发现异常,35例接受胫后神经SEP、正中神经SEP、VEP、NCV检查,分别有32例(91%)、23例(66%)、7例(20%)和15例(43%)发现异常。PT-SEP与脊髓MRI的阳性率存在显著差异(P<0.05),PT-SEP、MN-SEP、VEP、NCV的阳性率也存在显著差异(P<0.05)。结论:①神经电生理检查在SCD的诊断过程中具有较高的敏感性,对SCD的早期诊断具有重要的临床意义;②神经电生理检查可以反映SCD神经结构受累的范围及时序,对SCD的疾病预后判定有一定帮助。更多还原

【Abstract】 Objective:To explore the significance of electroneurophysiology test in early diagnosis and prognosis assessment of subacute comdined degeneration(SCD).Methods:35 patients with SCD were selected to receire spinal MRI,PT-SEP,MN-SEP,VEP and NCV respectively,and the positive rates from the tests were compared,and the difference of diagnostic sensibility and timing sequence of relevant nerve structure damages were observed.Results:Of 30 patients in the experiment who accepted spinal MRI,12 had abnormal symtoms;Of 35 patients who accepted PT-SEP,MN-SEP,VEP and NCV,32,23,7,15 had abnormal symtoms respectively.There existed significant difference of positive rate between spinal MRI and PT-SEP(32/35vs12/30,P<0.05),and between PT-SEP,MN-SEP,VEP andNCV(32/35 vs23/35vs7/35 vs 15/35,P<0.05).Conclusion:①Electroneurophysiology tests have higher sensibility than other tests in diagnosis of SCD,with the important clinical significance in early diagnosis;②Electroneurophysiology test can reflect the territory and timing sequence of nerve structure damage of SCD.It is helpfal for the prognosis assessment of SCD.更多还原