短暂性脑缺血发作患者事件相关电位的变化

背景短暂性脑缺血发作(transient ischemia attack, TIA)是临床常见的脑血管病之一,采用客观评测方法对其高级神经活动认知功能损害进行评估.目的研究 TIA患者的事件相关电位 (P300)的变化,探讨 TIA患者的认知损害及可能的机制.设计以诊断为依据,病例对照研究. 地点和对象在兰州军区乌鲁木齐总医院神经内科门诊及住院诊治的TIA患者 31例( TIA组),其中颈内动脉系统 9例,椎基底动脉系统 22例对照组均为来院体检的健康人30例. 干预对 TIA患者及正常对照组进行简易精神状态检查法 (MMSE)、听觉oddball刺激序列 P300检测及神经系统查体. 主要观察指标 MMSE评定分值,P3波潜伏期及 P3波幅测定. 结果 TIA组的 MMSE评分 [(27.13± 2.54)分 ],与对照组[(29.02± 1.35)分 ]比较 ,差异有显著性意义 (t=2.213, P< 0.05). P3波潜伏期TIA组 [(348.21± 20.33) ms]与对照组 [(330.32± 30.12) ms]比较 ,差异有显著性意义(t=2.732, P < 0.01);椎基底动脉系统 TIA比颈内动脉系统 TIA的 P3波潜伏期延长[(350.32± 31.21) ms,(339.32± 27.88) ms],差异有显著性意义 (t=2.479, P< 0.05);TIA患者的 P3波潜伏期延长与 TIA患者的发作次数呈正相关 (r=0.383,P<0.01),与 MMSE评分呈负相关 (r=-0.259,P< 0.05). 结论 TIA患者的 P3波潜伏期显著延长,存在早期认知功能的损害.TIA患者的早期认知损害与 TIA发作次数有关.

Change ofevent-related potential in patients with transient ischemia attack

BACKGROUND:Transient ischemia attack(TIA) is one of the commonly seen cerebrovascular diseases in clinical.Objective evaluating method is adopted to evaluate its effects on cognitive functions of higher nervous activities. OBJECTIVE:To study the changes of event-related potential(P300) in order to explore the cognitive damages of TIA patients,as well as its possible mechanism. DESIGN:Case control study based on diagnosis. SETTING and PARTICIPANTS:Thirty- one patients with TIA treated in the Out patient Clinic of Neurology,Chinese PLA Urumchi General Hospital of Lanzhou Military Area Command were chosen which included 9 cases of internal carotid artery system and 22 cases of vertebrobasilar artery system.Thirty healthy people coming for physical examination were selected as control group. INTERVENTIONS:Patients with TIA and people in the control group were taken Mini Mental State Examination(MMSE) test,hearing Oddball stimulus sequence P300 detection and examination of nervous system. MAIN OUTCOME MEASURES:Score of MMSE;latent period of P3 wave; amplitude of P3 wave. RESULTS:The MMSE score of TIA group and the control group was(27.13± 2.54) and(29.02± 1.35) respectively, there was significant difference between the two groups(t=2.213,P< 0.05).Compared with latent period of P3 wave in the control group[(330.32± 30.12)ms],there was significant difference between it and TIA group[(348.21± 20.33)ms](t=2.732, P< 0.01). The latent period of P3 wave in TIA patients of vertebrobasilar artery system[(350.32± 31.21)ms] was longer than that of patients with internal carotid artery system TIA[(339.32± 27.88)ms] with significant difference(t=2.479,P< 0.05).There was positive correlation between the prolonged latent period of P3 wave of TIA patients and the spasm frequency(r=0.383,P< 0.01) and negative correlation with MMSE score(r=-0.259,P< 0.05). CONCLUSION: Patients with TIA have greatly prolonged latent period of P3 wave and cognitive function damage in early stage. The early cognitive damage of TIA patients is related to the spasm frequency of TIA.