【摘要】 目的　探讨经颅磁刺激运动诱发电位 (MEP)异常与缺血性脑卒中患者临床病情之间的相关性及临床意义。方法　对 30例缺血性脑卒中患者分别进行经颅磁刺激 ,双侧外展小指肌 (ADM)记录运动诱发电位。结果　临床肌力 (0～ 5级 ) 4级以上者 11例患者在静止状态下可引出MEP波 ,10例肌力 3级者在轻收缩状态下可引出MEP波 ,肌力 0～ 2级的 9例患者不能引出MEP波。脑梗死组病侧中枢传导时间 (CMCT)比健侧明显延长由 (7.9± 0 .7)ms延长至 (10 .2± 0 .8)ms。通过对MEP波的潜伏期、波幅、中枢传导时间以及对照组 30例的MEP波进行统计学分析 ,发现MEP异常与临床运动功能障碍密切相关 ,能反映卒中患者病情的轻重。结论　经颅磁刺激运动诱发电位能较好地反应缺血性脑卒中患者的病情 ,可用于临床判断病情。更多还原

【Abstract】 Objective To investigate the correlation between the abnormalities of transcranial magnet stimulated motor evoked potentials (MEP) and clinical conditions of patients with cerebral infarction.Methods 30 cases of cerebral infarction patients and 30 age and sex matched healthy controls were examined for transcranial magnet stimulated MEP and complex muscle action potentials(CMAP) were recorded from abductor digiti minimi(ADM) and biceps brachii in bilateral upper extremities.Results The results showed that the cortical latency in paralyzed side was lengthened from (20.8±0.8)ms to (23.0±0.9)ms (P<0.01).Central motor conduction time (CMCT) in lesioned side was delayed from (7.9±0.7)ms to (10.2±0.8)ms (P< 0.01), while duration was widened from (16.9±1.1)ms to (20.7±1.3)ms (P< 0.01) and amplitude decreased from (0.9±0.6)mV to (0.4±0.2)mV (P<0.01) in the paralyzed side.Degree and site of MEP abnormalities is well correlated with clinical paralyzed sites as well as degree of muscle power.In group 1 with muscle power over grade 4,evoked potentials could be induced under no muscle contraction condition in all 11 cases,while in group 3 with muscle power less the grade 2,no potentials could be elicited in all 9 cases even under muscle contraction condition.Conclusions Transcranial magnetic MEP can be used to understand the functions of corticospinal tracts in patients with cerebral infarction and to judge the clinical severity of such patients.更多还原