轻度认知损害老年患者脑干听觉反应、P_(300)及脑电图的研究  

The brain auditory evoked potentials, P_(300) and electroencephalograph in the elderly with mild cognitive impairment

作　　者：陈炜[1] 张玲菊[2] 王建琴[2] 

机构地区：[1]浙江大学医学院附属第一医院精神科,310003 [2]浙江大学医学院附属第一医院神经电生理室,310003

出　　处：《中华精神科杂志》2004年第3期160-163,共4页Chinese Journal of Psychiatry

基　　金：浙江省教育厅资助项目(20010526)

摘　　要：目的 探讨轻度认知损害(MCI)患者的脑干听觉反应(BAEP)、事件相关电位(ERP)P300和脑电图(EEG)的特点,为早期痴呆的诊断提供帮助。方法 对38例MCI患者(MCI组)、26例阿尔茨海默病(AD)患者(AD组)进行BAEP和P300、EEC检查,并与20名健康老年人(健康组)作比较。结果 BAEP检查:MCI组与AD组左侧Ⅰ、Ⅱ波的差异均有显著性,P<0.05;MCI组与健康组比较,左、右侧Ⅳ、Ⅴ波的差异有显著性,P<0.05;AD组与健康组比较,左侧Ⅰ-Ⅳ波及右侧Ⅳ、Ⅴ波的差异均有非常显著性(P<0.01),右侧Ⅰ波差异有显著性(P<0.05)。P300检查,MCI组与AD组只在潜伏期的Pz点差异有显著性(P<0.05);MCI组与健康组在潜伏期Cz点差异有显著性(P<0.05);AD组与健康组比较,潜伏期的Fz、Cz、Pz点差异均有非常显著性(P<0.01),波幅的Cz点差异有显著性(P<0.05)。EEG显示,MCI组未见明显异常的18例,轻度异常17例,中度异常3例;AD组未见明显异常的1例,轻度异常8例,轻-中度异常9例,中度异常8例。结论 P300潜伏期的Pz点的改变可能有助于区分MCI和AD,而右侧Ⅳ、Ⅴ波的延长提示MCI患者可能有早期痴呆;EEG左侧颞部θ波增多提示MCI患者可能有早期AD。Objective To explore the characteristics of brain auditory evoked potentials (BAEP), P300 and electroencephalograph(EEG) in elderly patients with mild cognitive impairment (MCI). Methods The subjects were 38 cases with MCI, 26 patients with Alzheimer's Disease (AD) , and 20 healthy elderly as control (HC). The BAEP, P300 and EEG were recorded from each subject. Results As to BAEP, there were significant differences in the left side of wave Ⅰ,Ⅱ between patients with MCI and AD [ (1. 68±1.07) vs. (1.80±1. 12)ms, (2.69±1.06) vs. (2. 83±1. 09) ms, respectively; P < 0.05]; and the patients with MCI were different from HC in the left and right wave Ⅲ , Ⅳ[ (5. 02±1. 05) vs. (4.85±1.04) ms, (5. 87±1.04) vs. (5. 66±1.03) ms, (5.04±1.05) vs. (4.86±1.03) ms, (5. 84±1.05) vs. (5. 60±1.04) ms, respectively, P < 0. 05 ] ; AD were significantly different from HC in left wave Ⅰ,Ⅱ,Ⅲ, Ⅳ [ (1. 80±1. 12) vs. (1. 60±1. 10) ms, (2. 83±1. 09) vs. (2. 67±1. 06) ms, (3.91±1.06) vs. (3. 62±1.09) ms, (5. 11±1.07) vs. (4. 85±1.04) ms, respectively, P<0.01], and in the right side wave Ⅰ, Ⅳ, Ⅴ[(1. 74±1. 10) vs. (1.59±1.09)ms, P<0.05; (5. 11±1.06) vs. (4. 86±1.03) ms, (5.86±1.04) vs. (5.60±1.04) ms, P < 0.01, respectively]. As to the parameters of P300, the difference between MCI and AD was the latency at Pz [(365.97±1. 12) vs. (368. 16±1. 11) ms, P<0.05], between MCI and HC was the latency at Cz [ (429. 70±1. 20) vs. (429. 33±1. 18) ms, P <0. 05], between AD and HC were the latency at points of Fz, Cz , Pz [ (399.02±1.16) vs. (397. 17±1.20) ms, (429. 97±1. 21) vs. (429. 33±1. 18) ms, (368. 16±1.11) vs. (365. 44±1.11) ms, P<0.01], and the wave amplitude at Cz [(4. 11±2. 56) vs. (4.63±2.84) μV, P <0. 05]. In patients with MCI, the cases who had normal, mild, and middle abnormal EEG were 18, 17 and 3, respectively, while in patients with AD, the corresponding number were 1, 17 and 8, respectively. Conclusions The latency of P300 at point of Pz may be helpful to distinguish MCI and AD,

关 键 词：轻度认知损害 老年 脑干听觉反应 P300 脑电图 认知障碍 阿尔茨海默病 

分 类 号：R749.16[医药卫生—神经病学与精神病学]