摘要目的 探讨40 Hz听性稳态反应(40 Hz auditory steady-state response,40 Hz ASSR)对心肺复苏(cardiopulmonary resuscitation,CPR)后昏迷患者早期预后的预测价值.方法 对神经重症监护病房(neurological intensive care unit,NICU)收治的30例CPR后昏迷患者进行40 Hz ASSR和短潜伏期体感诱发电位(short-latence somatosensory evoked potentials,SLSEP)检查,并对两者进行分级.以转出NICU时为近期预后评价终点,将CPR后昏迷患者分为存活组(n=21)和死亡组(包括脑死亡,n=9),分析40 Hz ASSR和SLSEP分级与预后的相关性.结果 40 Hz ASSR(r=0.722,P=0.000)和SLSEP(r=0.430,P=0.018)分级与近期预后显著相关.40 Hz ASSR预测近期预后的特异性为100%,敏感性为77.8%,准确性为93.3%;SLSEP的特异性为61.9%,敏感性为88.9%,准确性为70.0%.结论 40Hz ASSR对CPR后昏迷患者具有一定预后价值,40 Hz ASSR分级越高,近期死亡可能性越大.

abstractsObjective To investigate the predictive value of early prognosis of the 40 Hz auditory steady-state response (40 Hz ASSR) in patients with coma following cardiopulmonary resuscitation (CPR). Methods Thirty patients with coma following CPR admitted in the Neurological Intensive Care Unit (NICU) were examined with the 40 Hz ASSR and shortlatency somatosensory evoked potential (SLSEP), and both were graded. Using transferred out of NICU as the short-term outcome end point, the patients with coma following CPR were divided into a survival group (n =21) and a death group (n =9; including brain death). The correlation between the 40 Hz ASSR and SLSEP grading and prognosis was analyzed. Results The grades of the 40 Hz ASSR (r = 0. 722, P = 0.000) or SLSEP (r = 0. 430, P = 0.018) was significantly correlated with the short-term prognosis. The sensitivity, specificity and accuracy of the 40 Hz ASSR for predicting the short-term prognosis were 77. 8%, 100% and 93.3%, respectively; and those of SLSEP were 88. 9%, 61. 9% and 70. 0%, respectively. Conclusions The 40 Hz ASSR has a certain prognostic value in patients with coma following CPR. The higher the grade of the 40 Hz ASSR is, the greater the likelihood of the recent death.