摘要
目的 评估脑干听觉诱发电位（BAEP）诊断脑死亡的准确性,以探讨其作为辅助检查在脑死亡诊断中的应用价值.方法 采用前瞻性观察性研究方法,选择2015年7月至2017年6月收住首都医科大学附属北京天坛医院重症医学科（ICU）的成年脑死亡患者（年龄≥18岁）进行BAEP监测,并以脑电双侧波形全部消失、双侧除Ⅰ波外所有波形消失或除一侧Ⅰ波外所有波形消失的监测结果作为阳性指标,评价其诊断脑死亡的敏感度（SEN）、阳性预测值（PPV）和假阴性率（FNR）.结果 共47例患者被纳入研究,其中43例完成BAEP监测与结果分析;而双侧波形全部消失、双侧除Ⅰ波外所有波形消失或除一侧Ⅰ波外所有波形消失3种BAEP结果诊断脑死亡的SEN为100%〔95%可信区间（95%CI）为90~100〕,PPV为100%（95%CI为89~100）,FNR为0%（95%CI为0~9）.结论 BAEP作为辅助检查在脑死亡的诊断中具有很高的准确性,可以在临床中得到更广泛的应用.
Objective To evaluate the diagnostic validity of application of brainstem auditory evoked potential （BAEP） as an ancillary test in patients with brain death.Methods A prospective observational study was conducted. Adult patients （≥ 18 years） with brain death were consecutively admitted to the Department of Intensive Care Unit （ICU） of Beijing Tiantan Hospital Affiliated to Capital Medical University from July 2015 to June 2017, and they further underwent BAEP monitoring. The following findings： absence of all waveforms at bilateral sides, absence of all waveforms except wave-Ⅰonly present at bilateral orunilateral side were set as the positive criteria of BAEP for the diagnosis of brain death, and its diagnostic sensitivity （SEN）, positive predictive value （PPV） and false negative rate （FNR） were further assessed.Results A total of 47 patients were enrolled in the study, and the 43 complete BAEP results were analyzed. The SEN, PPV and FNR of the above 3 types of diagnostic criteria （absence of all waveforms, and unilateral or bilateral presence of wave-Ⅰ only） were 100% [95% confidence interval （95%CI） 90-100], 100% （95%CI 89-100）, and 0% （95%CI 0-9）, respectively.Conclusion As an ancillary test, BAEP has extremely high validity for the diagnosis of patients with brain death, thus it should be used more extensively in clinical practice.
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2017年第6期581-585,593,共6页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
脑干听觉诱发电位
脑死亡
辅助检查
敏感度
阳性预测值
假阴性率
Brainstem auditory evoked potential
Brain death
Ancillary test
Sensitivity
Positive predictive value
False negative rate
