【摘要】 目的:探讨脑干听觉诱发电位(BAEP)对前庭周围性眩晕和中枢性眩晕的鉴别诊断价值。方法:对96例前庭系统性眩晕患者(研究组)及50名(100只耳)健康人(对照组)进行BAEP检查,观察两组Ⅰ、Ⅲ、Ⅴ波的潜伏期(PL)、波形分化情况,Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波的峰间潜伏期(IPL)、两耳侧间差(ILD)以及Ⅴ/Ⅰ波幅比值。对照组50名均为与研究组年龄、性别相匹配的健康人。结果:对照组Ⅰ、Ⅲ、Ⅴ波波形分化良好、重现性佳,各波PL及IPL均正常,Ⅱ-ⅤIPL<Ⅰ~ⅢIPL,同侧Ⅴ/Ⅰ波幅比值大于0.5,各波PL侧差(ILD)<0.4ms;研究组96例中有68例(71%)异常。两组的PL和IPL数值进行比较存在着显著性差异(P<0.01)。研究组68例BAEP异常者,依其表现分为两型。①内耳型28例,表现为Ⅰ波分化不良或波形消失,PL延长及其后各波相应延长,Ⅰ-ILD大于0.4ms;②脑干型40例,表现为Ⅰ波正常,Ⅲ波或Ⅴ波PL延长或波形消失,Ⅲ-Ⅴ、Ⅰ-Ⅴ的IPL延长,Ⅴ/Ⅰ波幅比小于0.5及双侧Ⅴ-ILD>0.4ms,两型之间的Ⅰ、Ⅲ、Ⅴ波PL及Ⅲ-Ⅴ、Ⅰ-Ⅴ的IPL存在着显著性差异(P<0.01),而Ⅰ-Ⅲ的IPL无显著性差异(P>0.05)。结论:BAEP是鉴别前庭系统周围性和中枢性眩晕比较敏感的诊断方法。更多还原

【Abstract】 Objective:To explore the differential diagnostic value of brainstem auditory evoked potential (BAEP) in patients with vestibular system peripheral or central vertigo.Methods:The BAEPs of 96 patients with vestibular vertigo and 50 health volunteers (100 ears),which used as control group,they were age- and sex-matched with those of experimental group,were detected.Meanwhile;the Peak Latency (PL)and change of waveform I、Ⅲ、Ⅴ,the interpeak latency(IPL)of waveform I-Ⅲ、Ⅲ-Ⅴ and Ⅰ-Ⅴ,the inter-ears latency difference (ILD)and amplitude ratio of wave Ⅴ/Ⅰwere observed and analyzed.Results:The BAEPs of control group showed:①fine differentiation and good reproducibility of waveform Ⅰ、Ⅲ、Ⅴ;②normal PL and IPL ③the IPL of wave Ⅲ-Ⅴ was less than those ofⅠ-Ⅲ;④the homolateral amplitude ratio ofⅤ:Ⅰexceed 0.5;⑤the ILD of various wave PL less than 0.4 milliseconds.However, in patients group,68 BAEP were abnormal,the abnormality rate was 71%(68/96).Two abnormal types were classified by their characteristics,as follow:①inner-ear type(28 cases):showing undifferentiating or disappearance of wave I,prolongation of PL in wave I and accordingly extended ILD of all later waves,the ILD of waveform I exceeded 0.4 milliseconds;②Brain-stem type(40 cases):showing normal wave I,prolonged PL or waveform disappearance of waves Ⅲ or Ⅴ.The IPL of waves Ⅲ-Ⅴ and I-Ⅲ were prolonged,and amplitude ratio of Ⅴ/Ⅰ was less than 0.5,and ILD of bilateral wave Ⅴ was more than 0.4 millisconds.The PL of wave I、Ⅲ、Ⅴ,IPL of Ⅲ-Ⅴ、Ⅰ-Ⅴ,homolateral IPL of wave I and Ⅴ,present significant difference between two types,oppositely,the IPL of I-Ⅲ was not significant difference.Conclusion:BAEP detection might be a more sensitive approach for differentiating vestibular system peripheral and central vertigo.更多还原