军人创伤后应激障碍患者的关联性负变异常变化及临床随访

A follow up study of contingent ne gative variation and psychiatric symptoms in patients with post-traumatic stress disorder.

目的 了解军人创伤后应激障碍 (PTSD)患者关联性负变 (CNV)的特征和治疗缓解后CNV的变化。方法 应用美国NicoletBravo型脑诱发电位仪及光、声两种成对刺激方法 ,对 6 6例发病期PTSD患者 (患者组 )和 5 6名健康军人 (对照组 )进行CNV测定以及症状自评量表 (SCL - 90 )和事件影响量表 (IES)评定 ,并对患者组中的 6 0例进行了临床随访。结果 患者组发病期M1潜伏期延迟 (P <0 0 1) ,M2 波幅增高 (P <0 0 1) ,命令信号后负变化(PINV)出现率增高 (P <0 0 1) ;SCL - 90及IES总分及其部分因子分升高 (P <0 0 1) ;CNV变异指标与SCL - 90及IES总分及其部分因子分显著相关 (P <0 0 1或 0 0 5 )。患者组康复期M1潜伏期、M2 波幅和PINV出现率 ,以及SCL- 90与IES总分及其部分因子分均恢复至正常值内 (与发病期比较P <0 0 1,与对照组比较P >0 0 5 ) ,且治疗前后CNV变异指标差值与精神症状减分率显著相关 (P <0 0 1或 0 0 5 )。结论 PTSD患者的CNV变化可能是状态标志。

Objective To investigat e the contingent negative variation(CNV) and psychiatric symptoms in patients with post-traumatic stress disorder (PTSD),the changes of CNV and psychiatric sympt oms between the duration of episode and remission.Methods The CNV was recorded with Nicolet Bravo model instrument and the psychiatric s ymptoms were evaluated with symptoms check list-90 (SCL-90) and impact of event scale (IES) from 66 episodic patients with PTSD,and 60 of them were retested wh en their psychiatric symptoms remitted.Results The episod ic patients showed significantly longer M 1 latency (P<0.01),increased M 2 amplitude (P<0.01),higher PINV rate (P<0.01) and scores of SCL-90 and IES,as compared with normal control.The remitted patients presented s teady CNV wave,shorter M 1 latency,lower M 2 amplitude,PINV rate and scores of SCL-90 and IES,as compared with their episodic state.The mostly items of CNV we re significantly related to changes of psychiatric symptoms.Conclusio ns It is suggested that the variations of CNV are the state maker of patients with PTSD.