P300评定卒中后抑郁患者认知功能对照研究的Meta分析

目的系统评价事件相关电位P300评定卒中后抑郁(post-stroke depression,PSD)患者认知功能的价值。方法采用STATA11.0软件对国内有关卒中后抑郁(PSD)患者事件相关电位P300的临床研究进行Meta分析。结果共纳入7项符合条件的病例对照研究,共907例研究对象,均包括卒中后抑郁组(PSD组,n=422),另对照组包括卒中无抑郁组(N-PSD组,n=265)和/或正常对照组(NC组,n=220),评价各组之间比较存在异质性,采用随机效应模型进行综合检验,结果为:①P300波幅:4项研究比较了PSD组与NC组P300波幅变化,结果显示PSD组较NC组P300波幅降低明显,差异具有显著统计学意义OR=-3.56,95%CI(-5.71,-1.40),P=0.001]。6项研究比较了PSD组与N-PSD组P300波幅变化,结果显示PSD组较N-PSD组P300波幅降低明显,差异具有显著统计学意义OR=-2.17,95%CI(-3.25,-1.09),P=0.000]。3项研究比较了N-PSD组与NC组P300波幅变化,结果显示N-PSD组较NC组P300波幅降低,差异具有统计学意义OR=1.92,95%CI(0.34,3.49),P=0.017];②P300潜伏期:4项研究同时报道了PSD组与NC组P300潜伏期变化,结果显示PSD组较NC组P300潜伏期明显延长,差异具有显著统计学意义OR=42.90,95%CI(26.58,59.21),P=0.000]。6项研究同时报道了PSD组与N-PSD组P300潜伏期变化,结果显示PSD较N-PSD组P300潜伏期明显延长,差异具有显著统计学意义OR=27.02,95%CI(15.89,38.15),P=0.000]。3项研究同时报道了N-PSD组与NC组P300潜伏期变化,结果显示N-PSD组较NC组P300潜伏期延长,差异具有显著统计学意义OR=-17.67,95%CI(-23.64,-11.70),P=0.000]。结论目前研究表明,与卒中后无抑郁患者及正常人相比,卒中后抑郁患者P300波幅显著降低、潜伏期明显延长;P300检测可为筛查卒中后抑郁患者早期认知功能损害的辅助指标。

The study of P300 on patients with post - stroke depression:a systematic review and Meta - analysis

Objective To evaluate the cognitive function of patients with post-stroke depression（PSD）by studying the value of that event-related potential P300 using meta-analysis and systematic review. Methods Meta analyses were applied to the domestic case-control studies of event related potential P300 for the patients with PSD using the software STATA 11.0. Results A total 7 clinical control trials with 907 cases are accepted,which include post-stroke depression group（PSD group,n=422） and post-stroke patients without depression（N-PSD group,n=265） and/or normal control group（NC group,n=220）,for evaluating the heterogeneity between those groups and testing with Random Effects Model.Amplitudes of P300：the changes of amplitudes between PSD group and NC group are compared in 4 studies,showing the amplitudes in PSD group lower than that in NC group with statistical significanceOR=-3.56,95%CI（-5.71,-1.40）,P=0.001].While compared between PSD group and N PSD group in 6 studies,the amplitudes in PSD group are lower than that in N-PSD group with statistical significanceOR=-2.17,95%CI（-3.25,-1.09）,P=0.000].The amplitudes of N-PSD group are lower than that in NC group in 3 studies between the two groups with statistical significanceOR=1.92,95%CI（0.34,3.49）,P=0.017].Latencies of P300：the changes of latencies between PSD group and NC group were reported in 4 studies,suggesting latencies in PSD group is significantly longer than that in NC groupOR=42.90,95%CI（26.58,59.21）,P=0.000].The changes between PSD group and N-PSD group in 6 studies are reported with the latencies in PSD group is significantly longer than that in N-PSD groupOR=27.02,95%CI（15.89,38.15）,P=0.000].The latencies of N-PSD group are significantly longer than NC group while compared between the two groups in 3 studiesOR=-17.67,95%CI（-23.64,-11.70）,P=0.000]. Conclusion The evidence in those studies reveals longer latencies and lower amplitudes of P300 in the patients of PSD can be applicable to evaluate the cognitive function of those patients and improve the efficiency of the diagnosis with PSD.