重型颅脑损伤恢复期患者的前瞻性记忆障碍的特征分析

Characteristics of prospective memory impairments in patients with severe traumatic brain injury during recovery stage

目的探讨颅脑损伤恢复期患者基于时间的前瞻性记忆（TBPM）和基于事件的前瞻性记忆（EBPM）的表现特点。方法选取2011年6月至2012年3月在中山大学附属第三医院康复医学科住院的重型颅脑损伤恢复期患者20例作为病例组，同期20名年龄、性别、受教育程度相匹配的健康人作为对照组，采用汉化版剑桥前瞻性记忆量表评估两组受试者TBPM和EBPM，记录TBPM分数、EBPM分数，各时间段监测时间的次数，对线索发现的次数，记笔记或用其他方法的情况。结果病例组[TBPM（9．05±3．59）分，EBPM（11．35±2．25）分]与对照组[TBPM（14．95±2．09）分，EBPM（16．45±1．54）分]相比，差异有统计学意义（P〈0．05），病例组监测时间次数[1（1，2）次]少于对照组[4（3，5．25）次]（P〈0．05），线索发现次数[2（2，3）次]少于对照组[5（4．25，5）次]（P〈0．05），病例组选择辅助记忆方法的受试者少于对照组（P〈0．05）。结论颅脑损伤患者TBPM和EBPM均受损，在干扰任务存在情况下对时间及事件的线索发现能力降低，实现前瞻性记忆功能的辅助记忆策略能力受损。

Objective To explore the characteristics of time-based prospective memory （TBPM） and event-based prospective memory （EBPM） in patients with severe traumatic brain injury （TBI） during recovery stage. Methods A total of 20 patients with severe TBI were recruited along with another 20 age, gender and education-matched healthy volunteers. The Chinese version of Cambridge Prospective Memory Test was used to assess the TBPM and EBPM characteristics. The TBPM score, EBPM score, time monitoring frequency, cue finding frequency, and whether or not the participants choose to take notes were recorded and compared between patients and controls. Results The TBPM and EBPM scores （9.05 ±3.59, 11.35 ±2.25 respectively） of TBI patients were lower than that of controls （ 14.95 ±2.09, 16.45 ± 1.54, respectively） （P 〈 0. 05 ）. Compared with the controls, time monitoring frequency of the patients [ times ] was less （ 1 （1,2） vs 4 （3, 5.25 ） times） （P 〈 0. 05） ; cue discovery frequency also less （2 （2, 3） vs 5 （4.25, 5） times）. And there were fewer note-taking subjects in TBI group （P 〈0.05）. Conclusion With deficits in both the time- and event-based prospective memory, the TBI patients have difficulty of finding time or event cue during interference and auxiliary memory strategy is rarely utilized to realize the prospective memory tasks.