老年期抑郁症患者认知功能障碍的P300检测及其意义

Study on Cognitive dysfunction of the major depression in Elderly by P300

目的探讨老年期抑郁症认知功能障碍的检测方法,分析其临床意义。方法采用配对研究法,分别使用听觉诱发电位P300(AEP-P300)和老年认知功能量表(SECF)对42例老年期抑郁症患者(观察组)及42名正常老年人(对照组)进行检测。结果SECF检测发现,观察组识记、广度、回忆1、回忆2、分类和总分等项目分值明显低于对照组,差异有统计学意义(P<0.05或P<0.01);P300检测发现,观察组P3潜伏期及反应时间明显延长(P<0.05及P<0.01),波幅明显降低(P<0.05),且P3潜伏期延长与病期、SECF总分呈负相关关系(r=-0.607,P<0.01);以P3潜伏期延长2个标准差为标准,P300异常率诊断与SECF检测的一致率为86.67%。结论老年期抑郁症患者的认知功能损害以注意、记忆功能障碍为主,SECF检测较为敏感,适合用于临床筛查,P300与SECF检测一致性好,是一种可靠的实验室检测方法。

Objective To explore the detection methods for cognitive dysfunction of the major depression in Elderly and analyze their clinical significance. Methods Using matched-pairs study, 42 patients with senile depressive disorders （ experimental group） and 42 normal aged people （ control group） were examined with auditory evoked potential P300 （event related potential, ERpop300） and SECF, respectively. Results It was found that the scores with registration, span, recall, classification and total score of the subjects in the experimental group were significantly lower than those in the control group （P 〈 0. 05 or 0. 01 ） ;the P3 latency and reaction time as revealed with P300 examination were significantly lengthened （P 〈 0. 05 or 0. 01 ）, and the amplitude of P300 was significantly lower （P 〈0.05）. It was also found that the prolongation of P3 latency and the reduction of the SECF total score were negatively related to the period of onset （ r = -0. 607,P 〈 0. 01 ）. Taking 2 standard deviations of lengthening of P3 latency as standard, the abnormal rate of P300 was 86.67% which was basically consistent with the diagnosis of the SECF. Conclusion Cognitive dysfunctions of senile depressive patients were mainly attention and memory disorders, the SECF detections were more sensitive and suitable for clinical screening, and the P300 was very consistent with the SECF and a reliable laboratory detection method.