原发性遗尿症儿童注意缺陷的事件相关电位研究

Attention impairment in children with primary nocturnal enuresis： an event-related potentials study

目的探讨原发性遗尿症儿童注意障碍的认知神经机制。方法遗尿症与正常儿童各20例，采用事件相关电位（ERP）注意持续性操作测试（CPT）任务，进行遗尿症与正常儿童Cz导联P2、N2、P3比较分析。结果1．行为学：遗尿组与正常组在反应时间、正确数、虚报数均差异无统计学意义（P〉0．05）。2．ERP：（1）Go条件下：遗尿组Go-N2潜伏期[（326．80±46．40）ms]、P3潜伏期[（438．80±62．60）ms]较正常组明显延长[（295．90±38．27）ms、（402．60±39．74）ms]，差异有统计学意义（P〈0．05）。（2）Nogo条件下：①波幅：遗尿症组N2波幅[（-10．55±3．30）μV]明显低于正常组[（-14．12±5．99）μV]差异有统计学意义（P〈0．05）；遗尿症组及正常组P2、P3波幅组内均差异无统计学意义（P〉0．05）。②潜伏期：遗尿症组P2潜伏期[（214．10±27．85）ms]长于正常组[（198．30±19．16）ms]，遗尿症组及正常组N2、P3潜伏期组内均差异无统计学意义（P〉0．05）。结论遗尿症儿童信息加工速度、注意冲突监测功能存在受损，引起注意缺陷，从而导致睡眠觉醒功能及排尿控制功能缺陷。

[ Abstract] Objective To explore the neural mechanism of attention impairment in children with primary nocturnal enuresis. Methods ERPs elicited by performing the continuous operation test （CPT） were assessed in 20 children with primary nocturnal enuresis and 20 normal children. The Go/Nogo measure- ments of enuretic group at central scalp （Cz） were compared with the normal children and analyzed. Results 1.Behavior results： there was no significant difference in the reaction time, the correct number and the false number between primary nocturnal enuresis and control group （P〉0.05）. 2. ERP：（ 1 ）Go stimulate：the laten- cy of Go-N2 and P3 of the children with primary nocturnal enuresis were longer than the normal control group （ Go-N2 ： （326.80±46.40） ms vs （ 295.90±38.27 ） ms, P3 ： （438.80±62.60） ms vs （ 402.60±39.74 ） ms ）, and the difference had statistic significance（P〈0.05 ）. （2） Nogo stimulate ： （1）Amplitude ： the amplitude of Nogo- N2 of the children with primary nocturnal enuresis were lower than that of the normal control group（ （ -10.55 ±3.30） μV vs （-14.12±5.99）μV） ,and the difference had statistic significance（P〈0.05）. There was no sig- nificant difference in the amplitude of Nog0-P2 and Nogo-P3（P〉0.05）.（2）Latency： the latency of Nogo-P2 of the children with primary nocturnal enuresis was longer than that of the normal control group （（ 214. 10± 27.85 ） ms vs （ 198.30± 19.16） ms ）, and the difference had staff stic significance （P〈 0.05 ） . There was no sig- nificant difference in the latency of Nogo-N2 and Nogo-P3 （P〉0.05）. Conclusion Attention impairment in children with primary nocturnal enuresis might be caused by the information processing speed and conflict monitoring function obstacle, but it is not because the reactive inhibition dysfunction, thus result in the lack of arousal function and bedwetting.