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甲状腺功能减退症的图形视觉诱发电位(PVEP)评估

Pattern visual evoked potential (PVEP) evaluation in hypothyroidism.

作者信息

Nazliel B, Akbay E, Irkeç C, Yetkin I, Ersoy R, Törüner F

机构信息

Faculty of Medicine, Gazi University, Ankara, Turkey.

出版信息

J Endocrinol Invest. 2002 Dec;25(11):955-8. doi: 10.1007/BF03344067.

Abstract

Dysfunction of the central nervous system (CNS) is an important consequence of thyroid hormone deficiency. Evoked potentials like visual evoked potentials (VEP) provide a reliable and objective measure of function in related sensory system and tracts. In this study pattern-shift VEP (PVEP) recordings were performed on 48 newly diagnosed hypothyroid patients. Twenty-four had sub-clinical and 24 had overt hypothyroidism. None of the patients had clinical symptoms or signs referable to CNS dysfunction. Their mean age was 44+/-12 yr. The response to pattern stimulation on the normal control subjects was a triphasic response with a prominent positive wave (P100) with a peak latency of 84-105 (mean: 96+/-4) milliseconds (ms). In patients with hypothyroidism mean P100 latency was (mean: 97+/-6) ms and the difference between the 2 groups was not statistically significant. (p>0.05) Delays above the average latency +/-2.5 SD of the mean of the control subjects was defined as a criteria for an abnormality. According to defined criteria 6 (12.5%) patients demonstrated abnormal PVEP at least on one tested side. Previous studies conducted on small patient populations stated there is high percentage of VEP abnormalities in hypothyroid patients. However, this fact was not confirmed by our study. We believe abnormalities of PVEP will be more prominent in untreated patients in the advanced stage of the disease, or in patients who have a neurological involvement; such as apathy, impaired memory or cerebellar dysfunction. Consecutive studies, in a more clearly defined and selected patient population, are needed to confirm and settle this issue.

摘要

中枢神经系统(CNS)功能障碍是甲状腺激素缺乏的一个重要后果。像视觉诱发电位(VEP)这样的诱发电位为相关感觉系统和神经束的功能提供了可靠且客观的测量方法。在本研究中,对48例新诊断的甲状腺功能减退患者进行了模式翻转VEP(PVEP)记录。其中24例为亚临床甲状腺功能减退,24例为显性甲状腺功能减退。所有患者均无中枢神经系统功能障碍的临床症状或体征。他们的平均年龄为44±12岁。正常对照组对模式刺激的反应是一个三相反应,有一个突出的正向波(P100),其峰值潜伏期为84 - 105(平均:96±4)毫秒(ms)。甲状腺功能减退患者的平均P100潜伏期为(平均:97±6)ms,两组之间的差异无统计学意义(p>0.05)。将高于对照组平均值±2.5标准差的平均潜伏期延迟定义为异常标准。根据定义的标准,6例(12.5%)患者至少在一侧测试中表现出异常的PVEP。先前对小患者群体进行的研究表明,甲状腺功能减退患者中VEP异常的比例很高。然而,我们的研究并未证实这一事实。我们认为,PVEP异常在疾病晚期未经治疗的患者或有神经受累的患者中会更明显,如冷漠、记忆力减退或小脑功能障碍。需要在更明确界定和选定的患者群体中进行连续研究,以证实并解决这个问题。

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