事件相关电位P300评估阿尔茨海默病患者认知功能障碍程度以及对老年精神分裂症的鉴别作用  

Event-related potential P300 in evaluating the degree of cognitive impairment in patients with Alzheimer disease and diagnosing schizophrenia in the elderly

作　　者：栾习云[1] 张仁惠[1] 郭季磊[1] 唐茂芹[2] 

机构地区：[1]山东省精神卫生中心特检科,山东省济南市250014 [2]山东省精神卫生中心精神科,山东省济南市250014

出　　处：《中国临床康复》2005年第13期14-15,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨阿尔茨海默病与老年精神分裂症患者P300的差异及P300在阿尔茨海默病患者认知功能障碍严重程度判断中的价值。方法:采用电生理技术检测2000-12/2003-12山东省精神卫生中心住院及门诊阿尔茨海默病患者38例及老年精神分裂症患者40例的P300。应用简明精神状态量表评定阿尔茨海默病患者的认知功能。结果:阿尔茨海默病患者P300检测结果中在Fz犤(402.50±3.77)ms犦、Cz犤(425.81±1.90)ms犦和Pz犤(366.31±1.61)ms犦3点P300潜伏期与老年精神分裂症患者相比均明显延长,差异有显著性(t=4.23,2.79,4.56;P均<0.01);在Fz犤(5.05±0.65)μV犦、Cz犤(3.93±0.56μV犦和Pz犤(7.97±0.73)μV犦3点波幅明显减低,与老年精神分裂症患者比较,差异有显著性(t=4.02,3.75,2.85;P均<0.01)。阿尔茨海默病患者P300在Fz,Cz及Pz3点潜伏期与简明精神状态量表分数显著负相关(r=-0.78,-0.76,-0.77,P均<0.01);在Fz,Cz及Pz3点波幅与简明精神状态量表分数显著正相关(r=0.77,0.78,0.75;P均<0.01)。结论:阿尔茨海默病患者P300在Fz、Cz与Pz3点潜伏期延长及波峰减低的现象与老年精神分裂症患者的差异以及与简明精神状态量表分数的关系,有助于对阿尔茨海默病患者认知功能受损程度的判断。AIM:To investigate the difference of P300 between patients with Alzheimer disease and elderly patients with schizophrenia,and evaluate the value of P300 in judging the severity of cognitive impairment of Alzheimer disease patients. METHODS:P300 of 38 Alzheimer disease patients and 40 elderly patients with schizophrenia,who were treated or hospitalized in the Shandong Mental Health Center from December 2000 to December 2003,were detected with the electrophysiological technique.The cognitive function of Alzheimer disease patients was assessed with the mini mental state examination(MMSE). RESULTS:The results of P300 detection showed that,the latencies at the sites of Fz, Cz and Pz in the Alzheimer disease patients[(402.50±3.77),(425.81±1.90),(366.31±1.61) ms] were significantly prolonged as compared with elderly patients with schizophrenia(t=4.23,2.79,4.56; P< 0.01),while the amplitude of wave at Fz, Cz and Pz sites[(5.05±0.65),(3.93±0.56),(7.97±0.73) μV] (t=4.02,3.75,2.85; P< 0.01). In the AD patients,the P300 latencies at Fz, Cz and Pz sites were significantly and negatively correlated with the scores of MMSE(r=-0.78,-0.76,-0.77,P< 0.01);the amplitudes of wave at Fz,Cz and Pz sites had significant positive correlation with the scores of MMSE(r=0.77,0.78, 0.75;P< 0.01). CONCLUSION:The differences of prolonged P300 latencies and decreased P300 wave amplitudes at Fz,Cz and Pz sites between Alzheimer disease patients and elderly patients with schizophrenia, as well as the correlation with the MMSE scores, are helpful to determine the severity of cognitive impairment of Alzheimer disease patients.

关 键 词：阿尔茨海默病 精神分裂症 事件相关电位 P300 认知 电生理学 

分 类 号：R749.1[医药卫生—神经病学与精神病学]