事件相关电位P_(300)和简易智能精神状态检查在轻微型肝性脑病检测中的价值  

Value of event-related potential P_(300) and mini-mental state examination in the diagnosis of minimal hepatic encephalopathy

作　　者：许统俭[1] 陈剑群[1] 董瑞国[1] 李昕[1] 耿德勤[1] 

机构地区：[1]徐州医学院附属医院消化科,江苏省徐州市221006

出　　处：《世界华人消化杂志》2007年第14期1662-1664,共3页World Chinese Journal of Digestology

摘　　要：目的:评价事件相关电位P_(300)和智能精神状态检查(MMSE)诊断轻微型肝性脑病(MHE)的价值.方法:30例肝炎后肝硬化患者进行事件相关电位P_(300)和脑诱发电位检查及MMSE检测,并观察1 a后临床肝性脑病(HE)的出现情况.结果:事件相关电位P_(300)异常21例(70.0%),体感诱发电位(SEP)异常11例(36.7%),MMSE得分<27(提示有认知功能障碍)13例(43.3%),事件相关电位P_(300)和/或MMSE异常22例(73.3%),两者均异常10例(33.3%),追踪观察1 a的23位患者中,17例事件相关电位P_(300)和/或MMSE异常患者出现临床肝性脑病12例,两者均无异常的6例患者中,出现临床肝性脑病1例,两者比较有显著性差异(70.6% vs 16.7%,P<0.05).结论:事件相关电位P_(300)和MMSE可作为判断肝硬化失代偿期是否发生轻微型肝性脑病的一种敏感又可靠的方法.AIM： To estimate the value of event related potential （ERP） P300 and mini-mental state examination （MMSE） in the detection of minimal hepatic encephalopathy （MHE）. METHODS： ERP P300 and somatosensory evoked potential （SEP） were examined, and MMSE were performed in 30 posthepatitic cirrhosis patients, and the occurrence of hepatic encephalopathy （HE） was observed 1 year after examination. RESULTS： Abnormal ERP P300 occurred in 21 patients （70.0%）, while abnormal SEP occurred in 11 （36.7%）. MMSE scores less than 27 were found in 13 （43.3%） cases, and both or either abnormity of ERP P300 and MMSE were observed in 22 （73.3%）. Ten cases （33.3%） were found with abnormity of both ERP P300 and MMSE. After 1 year, of the 17 patients with abnormity of ERP P300 and/or MMSE, 12 cases developed clinical hepatic encephalopathy, while of the 6 patients without abnormal ERP P300 and MMSE, only 1 case developed clinical hepatic encephalopathy. There was significant difference between them （70.6% vs 16.7%, P 〈 0.05）. CONCLUSION： ERP P300 and MMSE were sensitive and reliable to evaluate the occurrence of MHE in liver cirrhosis.

关 键 词：肝硬化 事件相关电位P300 智能精神状态检查 肝性脑病 

分 类 号：R747.9[医药卫生—神经病学与精神病学]