听觉P300对血管性痴呆早期诊断及鉴别诊断的价值

目的探讨P300对血管性痴呆(VD)的早期诊断及与Alzheimer病(AD)鉴别的价值.方法分别对20名正常人(NC)、20例VD患者、24例无痴呆脑梗死患者(CI)及20例AD患者进行神经心理学量表长谷川智力量表(HDS)评分,并选用听觉oddball序列分别对上述各组进行P300测试.结果 (1)VD组与CI组及NC组比较,N2、P3潜伏期(PL)明显延长(均P<0.05);P3PL与HDS评分呈负相关(r=-0.686,P＜0.01),且较HDS更为敏感;梗死部位与P300变化有一定关系,梗死位于颞叶、额叶的患者与其他梗死部位的患者相比,P3PL异常率明显增高(P＜0.05).(2)AD组与VD组相比,N1 PL更长,差异有显著性(P<0.05).结论 (1)P300对VD的早期诊断具有重要意义.(2)N1PL在VD与AD的鉴别诊断中有一定的意义.

The early diagnostic and differential diagnostic value of auditory P300 to vascular dementia

Objective To explore the value of P_ 300 in early diagnosis of vascular dementia (VD) and possibility of P_ 300 in the differential diagnosis between VD and Alzheimer's disease (AD).Methods Hasegawa Dementia Scale (HDS) and P_ 300 of oddball auditory evoked model were performed in 20 normal controls,20 patients with VD,24 patients with cerebral infarction without dementia (CI) and 20 patients with AD.Results The peak latency (PL) of target N_2 and P_3 in VD group was obviously longer than those in CI and NC groups,the difference was dramatic(all P < 0.05). There was a negative correlation between P_3PL and HDS( r = -0.686, P < 0.01),furthermore P_3PL was more sensitive than HDS. The location of infarction was correlated with P_ 300 . The patients with infarction of temporal lobe or frontal lobe had more prolonged P_3PL( P < 0.05). N_1PL in AD group was greatly prolonged in compare with that in VD group( P < 0.05).Conclusions P_ 300 may be of great importance in early diagnosis of VD. N_1PL can be used as objective evidence in differential diagnosis between VD and AD.