非痴呆性血管性认知损害患者P300的临床研究

目的：观察不同病变部位非痴呆性血管性认知损害（vascular cognitive impairment of non-dementia,VCIND）患者的P300,研究其神经心理学损害特征及可能的病理生理机制,同时探讨P300对早期血管性认知损害（VCI）的诊断价值.方法：对20例皮质下缺血性VCIND患者、20例皮质缺血性VCIND患者及15例正常对照（NC）进行P300检测.结果：与NC组比较,皮质下缺血性VCIND组患者P300潜伏期延长（366.85±26.43）ms vs（288.33±28.97）ms,P〈0.05],波幅降低（9.46±1.47）μV vs （13.51±1.30）μV,P〈0.05] 与皮质缺血性VCIND组比较,皮质下缺血性VCIND组患者P300潜伏期延长（366.85±26.43）ms vs（344.55±23.07）ms,P〈0.05],波幅比较差异无显著意义（P〉0.05）.结论：皮质下缺血性VClND组患者P300异常更为突出,与其神经心理学特征有关 P300潜伏期可能作为早期VCI的诊断参考指标之一.

The clinical research on P300 in patients with vascular cognitive impairment of non-dementia

Objective： To observe the characteristics of P300 and its diagnostic value in patients with two subtyped vascular cognitive impairment of non-dementia （VCIND）and investigate the characteristics of its electroneuropbysiology and pathophysiological mechanism. Methods： P300 was elicited from 20 cases of subcortical ischemic vascular cognitive impairment of non-dementia （SIVCIND） , 20 cases cortical isehemic vascular cognitive impairment of non-dementia （CIVCIND） and 15 normal controls, Results： （1）P300 elicited from patients with SIVCIND the bad prolonged latency （366.85 ± 26.43 ms vs 288.33± 28.97 ms）and decreased amplitudes （9.46±1.47 μV vs 13.51±1.30 μV） as compared with controls respectively（P〈0.05） ; （2）Latency （366.8± 526.43 ms vs 344, 55＋23.07 ms） of P300 elicited from SIVCIND was much attenuated as compared with CIVCIND （P〈0. 05） and the amplitudes were not obviously attenuated （P〈0.05）. Conclusion： The variation of P300 in patients with SIVCIND may be related to the features of neurology. The vascular lesion affects the subcortical cognitive circuit loop and the latency of P300 may be one of diagnostic index in the early stage of VCI.