Deschamps D, Garnier R, Lille F, Tran Dinh Y, Bertaux L, Reygagne A, Dally S
Service de médecine interne et de toxicologie clinique, Hôpital Fernand Widal, Paris, France.
Br J Ind Med. 1993 Apr;50(4):325-30. doi: 10.1136/oem.50.4.325.
Epidemiological studies have provided evidence that neuropsychiatric symptoms are induced by long term exposure to solvents; individual diagnosis with psychometric tests, however, is not always possible (for example, when the patient has linguistic difficulties). Therefore evoked potentials and cerebral blood flow were studied in 50 patients occupationally exposed to solvents who were referred to our department and for whom a solvent induced psycho-organic syndrome was suspected. Degree of exposure was evaluated by its duration (mean 13.9, range 1 to 37 years) and its intensity (from an interview). At the group level, P22 and N35 latencies and amplitude N20-P22 of somatosensory evoked potentials were higher in cases than in controls (p < 0.05), whereas there was no difference for brainstem and visual evoked potentials, nor for hemispheric cerebral blood flow (but a higher distribution in the left occipital region was seen in patients, p < 0.05). Some parameters were linked to degree of exposure (amplitude N20-P22 of somatosensory evoked potentials, interpeak latency I-V of brainstem evoked potentials, distribution of cerebral blood flow in the internal frontal left region). At the individual level, these examinations were not of diagnostic value because sensitivity was low.
流行病学研究已提供证据表明，长期接触溶剂会诱发神经精神症状；然而，通过心理测量测试进行个体诊断并非总是可行（例如，当患者存在语言障碍时）。因此，我们对50名因职业接触溶剂而被转诊至我科且疑似患有溶剂诱发的精神器质性综合征的患者进行了诱发电位和脑血流量研究。通过接触时长（平均13.9年，范围1至37年）及其强度（通过访谈）评估接触程度。在组水平上，体感诱发电位的P22和N35潜伏期以及N20 - P22波幅在病例组中高于对照组（p < 0.05），而脑干诱发电位和视觉诱发电位以及半球脑血流量均无差异（但患者左枕叶区域的分布较高，p < 0.05）。一些参数与接触程度相关（体感诱发电位的N20 - P22波幅、脑干诱发电位的I - V峰间潜伏期、左额叶内侧区域的脑血流量分布）。在个体水平上，这些检查无诊断价值，因为敏感性较低。
