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[早产儿下肢的体感诱发电位]

[Somatosensory evoked potential of the lower extremity in the premature neonate].

作者信息

Tranier S, Chevallier B, Lemaigre D, Liot F, Lagardère B, Gallet J P

机构信息

Service central d'explorations fonctionnelles, hôpital Ambroise-Paré, Boulogne, France.

出版信息

Neurophysiol Clin. 1990 Dec;20(6):463-79. doi: 10.1016/s0987-7053(05)80103-0.

Abstract

The morphology of SEP is a good index of cortical maturation. Cerebral SEP is elicited by stimulation of the posterior tibial nerve at 38 wk post-conceptional age in 37 neonates distributed in 3 groups: I = gestational age (GA) at birth less than 31 wk; II = GA 23-36 wk; III = full-term neonates (FTN). A somatosensory response was identified in only 21 cases (56.8%). The presence of SEP in 3 groups, ie I, II, III, was 45.5%, 53.8% and 69.2% respectively. The morphological characteristics studied (latencies, amplitude and rising time) in these neonates were different: the peak latencies of major positive wave (P1) and rising time were not significantly different between I and III. These parameters were statistically different between II and III. SEP development is linked to some morphological factors-height, and growth-but also to the maturation of the central nervous system (myelinisation and central pathway organization). These results indicate that until 38-39 wk post-conceptional age, the maturation of the central somatosensory pathway is variable at different birth periods; this suggest the possible role of extra-uterine factors of in the acceleration of neurological development.

摘要

体感诱发电位(SEP)的形态是皮质成熟的良好指标。对37例新生儿在孕龄38周时刺激胫后神经引出大脑SEP,这些新生儿分为3组:I组=出生时胎龄(GA)小于31周;II组=GA 23 - 36周;III组=足月儿(FTN)。仅在21例(56.8%)中识别出体感反应。3组(即I组、II组、III组)中SEP的出现率分别为45.5%、53.8%和69.2%。对这些新生儿研究的形态学特征(潜伏期、波幅和上升时间)有所不同:I组和III组之间主要正波(P1)的峰值潜伏期和上升时间无显著差异。II组和III组之间这些参数存在统计学差异。SEP的发育与一些形态学因素——身高和生长——有关,但也与中枢神经系统的成熟(髓鞘形成和中枢通路组织)有关。这些结果表明,在孕龄38 - 39周之前,中枢体感通路的成熟在不同出生时期是可变的;这提示宫外因素在加速神经发育中可能发挥的作用。

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