脑梗死后轻度认知障碍患者的事件相关电位P300波及注意力变化的特点

The Characterization of P300 and Attention Diversify in Patients of Mild Cognitive Impairment after Cerebral Infarction

目的通过探讨脑梗死后轻度认知障碍(MCI)患者事件相关电位(ERP)P300波和注意力变化的特点以及它们与简易精神状况检查(MMSE)得分的相关性,判定这些指标对患者有无认知障碍和认知障碍程度以及对患者预后的预测是否有重要的临床应用价值。方法采用上海NPI-200P+海神号神经电诊仪对30例脑梗死后MCI患者(MCI组)、30例脑梗死后认知功能正常患者(非MCI组)和21例正常人(对照组)进行ERPP300波检测。使用MMSE和注意力评价量表评估研究对象的认知功能及注意力变化情况,同时分析3组研究对象P300波潜伏期及注意力评价量表得分与MMSE得分的相关性。结果和对照组相比,MCI组P300波潜伏期显著延长,波幅明显降低,注意力有较明显的障碍。注意力与MMSE得分降低和P300潜伏期延长有明显的相关性。结论脑梗死后MCI患者早期可出现注意力改变的临床特点。P300波较MMSE敏感,能更早地反映细微的认知障碍或智能障碍,对于早期确诊MCI的患者有无认知障碍及认知障碍程度有很重要的临床应用价值。

Objective To investigate the feature of P300 parameter and attention diversify in cerbral infarction patients with cognitive impairment,and the correlation between them and the scores of MMSE,and value of P300 in prognostic prediction and early diagnosis MCI.Methods To select cerebral infarction patients as research objects,and carry out random synchronization control verification investigate.Auditory stimulation P300 was studied separately in 30 MCI patients with cerebral infarction,30 normal cognition patients with cerebral infarction and 21 normal persons,meanwhile MMSE and attention evaluation were measured to analyze their correlation.Results To compare with NC group,the peak latencies of P300 in MCI group were significantly delayed and the amplitude of P300 was significantly decreased（P 0.005）.The MCI group exists evident attention deficit,the difference has significance to compare with NC group（P 0.05）,there is statistics difference between two groups.By correlation analysis,we discovered P300 latency had a close negative correlation with the score of MMSE and attention.Conclusion In early stage,it was discovered that the patients＇ attention diversify in Patients of Mild Cognitive Impairment after Cerebral Infarction.P300 can reflect cognitive function of the patients objectively,and it is more sensitive than MMSE,it can reflect fine cognitive or intellective dysfuntion in early stage.The detecting P300 has importantly clinical value for early diagnosis of the patients with cognitive dysfunction and the severity of cognitive dysfunction,and prognosis of the patients.