事件相关电位P300、TCD检测对多发性脑梗死认知功能的评价

目的探讨多发性脑梗死后事件相关电位P300、经颅多普勒超声(TCD)检测对认知功能障碍的评判价值。方法采用P300检测病例组60例多发性脑梗死患者(经痴呆简易筛查量表BSSD测评再分为多发性脑梗死痴呆组38例,多发性脑梗死非痴呆组22例),30例正常对照组,对比分析痴呆、非痴呆组两组之间以及两组分别与正常对照组之间的P300结果;采用TCD检测病例组60例多发性脑梗死患者,分析颅内动脉各血流参数变化,并与P300潜伏期、波幅作对比分析。结果①P300检测多发性脑梗死患者的P300潜伏期比正常对照组明显延长,波幅明显降低(均P<0.05);痴呆、非痴呆组分别与正常对照组比较,P300潜伏期延长、波幅降低,均有统计学意义(P<0.05),但痴呆组与非痴呆组间P300潜伏期及波幅差异均无统计学意义(P>0.05);②TCD检测:总异常率为93.33%。符合血管狭窄36/60例(60.0%)、狭窄后慢性闭塞性改变12/60例(20.0%)、动脉硬化性血流改变32/60例(53.33%);流速正常12例。痴呆组和非痴呆组两组间TCD血流速度差异无统计学意义;TCD血流速度与P300潜伏期具有相关性。结论 P300对认知功能的评定优于痴呆简易筛查量表(BSSD);P300、TCD联合检测是评判认知功能的良好指标,为脑梗死后患者血管性痴呆的早期发生与发展提供了可靠依据。

Evaluation of Event-related Potential P300 and TCD Detection on Cognitive Function of Multiple Cerebral Infarction

Objective To investigate the judgement value of the event-related potentials P300 and Transcranial Doppler ultrasound(TCD) on cognitive impairment of multiple cerebral infarction use.Methods 60 patients with multiple cerebral infarction(38 cases multi-infarct dementia and 22 cases with multiple infarct non-dementia) and 30 normal controls were detected by P300 method.Comparative analysis was performed among groups.Results 1.P300 testing: P300 latency in multi-infarct patients was significantly longer than that in normal control group and amplitude in multi-infarct patients was significantly reduced compared to that in normal control group;Difference of P300 latency and amplitude between dementia group and non-dementia group showed no significant difference;Compared P300 latency and amplitude of the control group with those of dementia group and non-dementia group respectively,significant difference were found.2.TCD detection: Total abnormal rate was 93.33% in which the stenosis 36/60 cases(60.0%),the narrow chronic occlusive 12/60 cases(20.0%) and atherosclerotic changes in blood flow 32 / 60 cases(53.33%).Conclusion P300 assessment is better than simple dementia screening scale(BSSD) in evaluation of cognitive function.Evaluation of cognitive function using P300 united with TCD is a good indicator for cerebral infarction in patients with early onset of dementia for assessment of the degree of vascular dementia.