血管性认知功能障碍患者的神经心理学、影像学及事件相关电位的研究

Study on neuropsychology, imageology and event-related potential in patients with vascular cognitive impairment

目的 研究血管性认知功能障碍 (VCI)患者的神经心理学、影像学及事件相关电位的特点并探讨其意义。方法 对 78例VCI患者及 4 9名正常人进行中文版简易智能状态检查 (MMSE)量表、头颅CT、事件相关电位检查。结果 (1)VCI组MMSE总分 (2 4 .35± 3.2 8)分 ,与正常组 (2 5 .0 4± 5 .0 3)分比较差异无显著性(P >0 .0 5 ) ;地点定向、时间定向、短程记忆、计算能力、语言表达、言语复述、图形描画 7项亚项的评分均明显低于正常组 (均P <0 .0 5 )。 (2 )VCI患者脑萎缩明显 ,脑梗死灶位于额、颞叶者及多发性梗死患者MMSE评分降低更显著 (均P <0 .0 5 )。 (3)VCI患者P3 0 0 潜伏期与正常组相比显著延长 (P <0 .0 5 ) ,P3 0 0 潜伏期与MMSE评分呈负相关 (r=- 0 .6 1,P <0 0 5 )。结论 MMSE量表中认知功能亚项的测评 ,有利于早期发现VCI患者的认知功能障碍 ,脑萎缩及脑梗死灶的部位和数目与VCI的程度有关 ;P3 0 0 潜伏期的检测对于早期发现VCI患者的认知障碍及其程度有重要价值。

Objective To investigate the characteristic and significance of neuropsychology, imageology and event-related potential(ERP) in patients with vascular cognitive impairment (VCI).Methods 78 VCI patients and 49 normal subjects were studied with mini mental state examination(MMSE), brain CT scan and ERP.Results (1)There was no significant difference of MMSE scores between VCI group( 24.35± 3.28)and control group ( 25.04± 5.03)( P> 0.05). The scores of sub items of MMSE including place orientation,time orientation,short time memory,account ability,language expression,language repetition,figure portrayal in patients with VCI were lower than those in normal subjects (all P< 0.05). (2)Brain atrophy in patients with VCI was notable. The scores of MMSE in the patients with multi infarct and infarct in frontal or temporal lobe were obviously lower than other patients. (3)The P 300 latencies were significantly prolonged in VCI patients compared with those in normal subjects( P<0.05), and the prolongation of P 300 latency was related to the score of MMSE( r= -0.61, P<0.05).Conclusion The test of sub items of MMSE helps early finding of cognitive impairment in VCI patients, and the degree of cognitive impairment is related to the brain atrophy,the location of infarct and the number of infarct. The detecting of P 300 has important value in early diagnosis of the patients with cognitive impairment and its severity.