He F, Liu X, Yang S, Zhang S, Xu G, Fang G, Pan X
Institute of Occupational Medicine, Chinese Academy of Preventive Medicine, Beijing.
Environ Res. 1993 Feb;60(2):213-26. doi: 10.1006/enrs.1993.1029.
The median nerve somatosensory evoked potentials (SEP), pattern reversal visual evoked potentials (VEP), and brain stem auditory evoked potentials (BAEP) were studied in 109 healthy adults and in 88 patients with acute carbon monoxide (CO) poisoning. The upper limits for normal values of peak and interpeak latencies of multimodalities of evoked potentials in the reference group were established by a stepwise multiple regression analysis. SEP changes selectively affecting N32 and N60 were found in 78.8% of patients. There was prolonged P100 latency of VEP in 58.2% of the cases examined. The prevalence of BAEP abnormalities in comatose patients (36%) was significantly higher than that (8.6%) in conscious patients. BAEP abnormalities were most frequently seen in comatose patients who had diminished brain stem reflexes (77.8%). It has been found that a consistent abnormality involving N20 and subsequent peaks in SEP, a remarkable prolongation of P100 latency in VEP, or a prolongation of III-V interpeak latency in BAEP as well as the reoccurrence of evoked potential abnormalities after initial recovery all indicate unfavorable outcomes in patients with acute CO poisoning. The multimodality evoked potentials have proved to be sensitive indicators in the evaluation of brain dysfunction and in the prediction of prognosis of acute CO poisoning and the development of delayed encephalopathy.
对109名健康成年人和88例急性一氧化碳（CO）中毒患者进行了正中神经体感诱发电位（SEP）、图形翻转视觉诱发电位（VEP）和脑干听觉诱发电位（BAEP）研究。通过逐步多元回归分析确定了参照组中多种诱发电位的峰潜伏期和峰间潜伏期的正常上限值。在78.8%的患者中发现SEP变化选择性地影响N32和N60。在58.2%的受检病例中VEP的P100潜伏期延长。昏迷患者中BAEP异常的发生率（36%）显著高于清醒患者（8.6%）。BAEP异常最常见于脑干反射减弱的昏迷患者（77.8%）。已发现，SEP中涉及N20及后续波峰的持续异常、VEP中P100潜伏期的显著延长、BAEP中Ⅲ-Ⅴ峰间潜伏期的延长以及初始恢复后诱发电位异常的再次出现均提示急性CO中毒患者预后不良。多种诱发电位已被证明是评估脑功能障碍以及预测急性CO中毒预后和迟发性脑病发生的敏感指标。
