中国帕金森病患者认知功能障碍P300研究的Meta分析

P300 for the assessment of cognitive disorders in Chinese patients with Parkinson＇ s disease： a Metaanalysis

目的 用meta分析方法评估P300应用于帕金森病（Parkinson＇s disease,PD）患者认知功能障碍评估的临床价值.方法 计算机检索中英文数据库,收集不同认知障碍[痴呆、轻度认知障碍（mild cognitive impairment,MCI）和无认知损害;前两者合称“认知功能障碍”,后两者合称“非痴呆”]PD患者及健康对照的P300对比研究,病例组和对照组性别和年龄构成匹配的研究为高质量研究.用Meta分析计算组间P300潜伏期和波幅的加权均数差（WMD）.结果 共计23项研究纳入分析,其中20项为高质量研究.痴呆PD患者的P300潜伏期显著长于非痴呆PD患者（WMD：56.14,95％CI：19.06,93.23）,波幅则显著短于非痴呆帕金森患者（WMD：-1.30,95％CI：-2.08,-0.51）;MCI帕金森患者的P300潜伏期显著长于无认知障碍的PD患者（WMD：13.71,95％CI：5.13,22.29）,波幅则显著短于无认知障碍的PD患者（WMD：-1.25,95％CI：-2.29,-0.21）;但痴呆和MCI帕金森患者的P300潜伏期（WMD：4.16,95％CI：-13.85,22.17）和波幅（WMD：0.23,95％ CI：-1.72,2.17）均差异无统计学意义.结论 中国PD患者中痴呆和非痴呆、MCI和无认知损害者P300差异明显,但痴呆和MCI P300无明显区别.

Objective To assess the clinical utility of P300 for the assessment of cognitive disorders in Chinese patients with Parkinson＇s disease （PD） by meta-analysis.Methods Studies comparing the P300 between PD patients with different cognitive disorders （dementia,mild cognitive impairment （MCI）,and no cognitive impairment;the former two were “cognitive impairments”,while the latter two were “nondementia”） and healthy controls were retrieved by searching within major Chinese and English databases.Studies,whose case and control groups were matched for age and gender,were rated as high quality.Weighted mean differences （WMDs） in P300 latency and amplitude between groups were calculated by using meta-analysis.Results In total,23 studies were included and 20 of which were rated high quality.Demented PD patients had statistically significant longer P300 latency （WMD：56.14,95% CI：19.06,93.23） and lower amplitude （WMD：-1.30,95%CI：-2.08,-0.51） than non-demented PD patients.PD patients with MCI had statistically significant longer P300 latency （WMD：13.71,95%CI：5.13,22.29） and lower amplitude （WMD：-1.25,95 % CI：-2.29,-0.21） than PD patients without cognitive disorders.However,no significant differences in P300 latency （WMD：4.16,95% CI：-13.85,22.17） and amplitude （WMD：0.23,95% CI：-1.72,2.17） were found between PD patients with dementia and MCI.Conclusion Among Chinese PD patients,there are significant P300 differences between those with dementia and without dementia,and between MCI and those without cognitive impairments,however,but no significant P300 differences between those with dementia and MCI.