Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
J Clin Neurophysiol. 2010 Feb;27(1):25-9. doi: 10.1097/WNP.0b013e3181cb4282.
To explore the prognostic accuracy for unfavorable outcome with short-latency somatosensory evoked potential (SLSEP) and brainstem auditory evoked potential (BAEP) in patients with severe stroke, 100 acute severe supratentorial stroke patients [Glasgow Coma Scale, (GCS) <or=12] were monitored with SLSEP, BAEP, and GCS within 1 week after onset. All patients were evaluated with modified Rankin scale 6 months after onset-0 to 4 being favorable outcome, whereas 5 to 6 designated unfavorable outcome. Correlations between SLSEP, BAEP, or GCS and prognosis were analyzed respectively. Of all 100 patients, 92 suffered unfavorable outcome, only 8 had favorable outcome. GCS 3 to 8 was significantly correlated with unfavorable outcome (P < 0.01). Absence of cortical SLSEP (N20 response, at least one side), abnormal bilateral N20-P25 amplitude ratio, Cant grading 3, Judson grading 3, and Haupt grading 3 to 4 were all significantly correlated with unfavorable outcome (P < 0.01). Poor differentiation or absence of BAEP wave V, Cant grading 3, Hall grading 3 to 4, and Haupt grading 3 to 4 were all significantly correlated with unfavorable outcome (P < 0.01). Absence of SLSEP N20, poor differentiation or absence of BAEP wave V, and Hall and Haupt grading of BAEP were acceptably consistent with prognosis (kappa >0.4). Prognostic accuracy of SLSEP, BAEP, and GCS for unfavorable outcome was very high (94.3%-98.7%), among which BAEP is the highest (97.5%-98.7%). The overall prognostic accuracy of SLSEP (90.5%-93.7%) was higher than BAEP (83.0%-89.4%) and GCS (82%). The prognostic accuracy of SLSEP and BAEP for unfavorable outcome in patients with severe supratentorial stroke was high, whereas for favorable outcome, it was low. The overall prognostic accuracy was higher than GCS.
为了探究短潜伏期体感诱发电位（SLSEP）和脑干听觉诱发电位（BAEP）对重症脑卒中患者不良预后的预测准确性，对 100 例急性重症幕上脑卒中患者[格拉斯哥昏迷量表（GCS）评分≤12]进行了 SLSEP、BAEP 和 GCS 监测，这些患者在发病后 1 周内接受了监测。所有患者在发病 6 个月后均采用改良 Rankin 量表进行评估，0 至 4 分为预后良好，5 至 6 分为预后不良。分别分析了 SLSEP、BAEP 或 GCS 与预后的相关性。在这 100 例患者中，92 例患者预后不良，只有 8 例患者预后良好。GCS 评分 3 至 8 分与预后不良显著相关（P<0.01）。皮质 SLSEP 缺失（N20 反应，至少一侧）、双侧 N20-P25 振幅比异常、Cant 分级 3 级、Judson 分级 3 级和 Haupt 分级 3 至 4 级均与预后不良显著相关（P<0.01）。BAEP 波 V 分化不良或缺失、Cant 分级 3 级、Hall 分级 3 至 4 级和 Haupt 分级 3 至 4 级与预后不良显著相关（P<0.01）。SLSEP 缺失 N20、BAEP 波 V 分化不良或缺失、以及 BAEP 的 Hall 和 Haupt 分级与预后具有较好的一致性（kappa>0.4）。SLSEP、BAEP 和 GCS 对预后不良的预测准确性均很高（94.3%-98.7%），其中 BAEP 最高（97.5%-98.7%）。SLSEP 的总体预后准确性（90.5%-93.7%）高于 BAEP（83.0%-89.4%）和 GCS（82%）。SLSEP 和 BAEP 对重症幕上脑卒中患者不良预后的预测准确性较高，而对预后良好的预测准确性较低。总的来说，其预测准确性高于 GCS。
