急性脑梗死患者认知功能障碍事件相关电位N300的临床研究

目的 探讨急性脑梗死患者早期认知功能障碍的特点及其事件相关电位(ERPs)N300的特征.方法 选取急性脑梗死患者30例作为脑梗死组,健康老年人30例作为对照组.分别对2组受试者进行图片再认测验,现场采集并记录脑电图波形,对2组受试者所诱发的ERPs数据结果进行统计学分析.同时采用简易精神状态检查表(MMSE)评定2组受试者认知功能,并与ERPs进行相关性分析.结果 脑梗死组图片再认的反应时间为(798.63±49.32)ms,对照组为(765.21±35.67)ms,差异有统计学意义(P<0.05).脑梗死组图片再认的正确率为(59.75±8.45)%,对照组为(65.26±9.28)%,差异有统计学意义(P<0.05).脑梗死组所诱发N300波幅低于对照组(P<0.01),潜伏期长于对照组(P<0.01).脑梗死组潜伏期和波幅与MMSE评分呈线性相关(P<0.05).结论 急性脑梗死患者存在不同程度认知功能损害;采用ERPs评价脑梗死患者的早期认知功能损害具有一定的临床意义,可作为以量表为基础的认知功能辅助评定工具.

Abstract：

Objective To determine the characteristics of early cognitive dysfunction and N300 event-related potentials(ERPs)in patients with acute cerebral infarction(ACI).Methods Thirty patients with ACI and thirty normal healthy elderly people were studied.The two groups were examined with a picture recognition test and EEG waveforms were recorded.The ERPs were analysed statistically.The mini-mental state examination(MMSE) was used to evaluate cognitive function,and the results were correlated with the ERPs. Results The average MMSE scores of the ACI and control groups were significantly different.Reaction times(RTs)in the picture recognition test were(798.63±49.32)ms in the ACI group and(765.21±35.67)ms in the control group,a difference significant at the 5% confidence level.The average accuracy rates,(59.75±8.45)%and(65.26±9.28)%,were also significantly different.Average N300 ERPs the in the ACI group were significantly lower than those in the control group,and the average latencies were significantly longer.Both latency and amplitude in the ACI group showed a linear correlation with MMSE scores. Conclusion The ERPs of ACI patients have some clinical significance,and can be used as a scale-based assessment of cognitive function.