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严重卒中发病后4至7天评估的体感诱发电位和脑干听觉诱发电位可预测不良预后。

Somatosensory and Brainstem Auditory Evoked Potentials Assessed between 4 and 7 Days after Severe Stroke Onset Predict Unfavorable Outcome.

作者信息

Zhang Yan, Su Ying Ying, Xiao Shu Ying, Liu Yi Fei

机构信息

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Department of Neurology, Luhe Hospital, Capital Medical University, Beijing 100053, China.

出版信息

Biomed Res Int. 2015;2015:196148. doi: 10.1155/2015/196148. Epub 2015 Dec 21.

Abstract

Our objective was to explore the best predictive timing of short-latency somatosensory evoked potentials (SLSEP) and brainstem auditory evoked potentials (BAEP) for unfavorable outcomes in patients with early stage severe stroke. One hundred fifty-six patients with acute severe supratentorial stroke were monitored according to SLSEP, BAEP, and the Glasgow Coma Scale (GCS) at 1-3 days and 4-7 days after the onset of stroke. All patients were followed up for outcomes at 6 months after onset using the modified Rankin Scale (mRS), with a score of 5-6 considered unfavorable. The predictive values of SLSEP, BAEP, and the GCS at 1-3 days were compared with 4-7 days after onset. Our results show that, according to the analysis of prognostic authenticity, the predictive values of SLSEP and BAEP at 4-7 days after stroke onset improved when compared with the values at 1-3 days for unfavorable outcomes. Most of the patients with change of worsening evoked potentials from 1-3 days to 4-7 days after onset had unfavorable outcomes. In conclusion, SLSEP and BAEP assessed at 4-7 days after onset predicted unfavorable outcomes for acute severe stroke patients. The worsening values of SLSEP and BAEP between 1-3 days and 4-7 days also present a prognostic value.

摘要

我们的目的是探讨早期重症卒中患者短期潜伏期体感诱发电位(SLSEP)和脑干听觉诱发电位(BAEP)对不良预后的最佳预测时机。对156例急性重症幕上卒中患者在卒中发作后1 - 3天和4 - 7天根据SLSEP、BAEP和格拉斯哥昏迷量表(GCS)进行监测。所有患者在发病6个月后采用改良Rankin量表(mRS)进行预后随访,mRS评分5 - 6分被视为不良预后。比较发病后1 - 3天与4 - 7天SLSEP、BAEP和GCS的预测价值。我们的结果表明,根据预后真实性分析,卒中发作后4 - 7天SLSEP和BAEP对不良预后的预测价值较1 - 3天有所提高。大多数发病后1 - 3天至4 - 7天诱发电位恶化的患者预后不良。总之,发病后4 - 7天评估的SLSEP和BAEP可预测急性重症卒中患者的不良预后。SLSEP和BAEP在1 - 3天至4 - 7天之间的恶化值也具有预后价值。

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