重型颅脑损伤视觉听觉P300特征及与智商的相关性  

The features of visual and auditory P300 and correlations of intelligence quotient in severe traumatic brain injury

作　　者：刘子龙[1] 陈凯[1] 刘良[1] 陈晓瑞[1] 饶广勋[1] 李海霞[2] 

机构地区：[1]华中科技大学同济医学院法医学系,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院儿科,湖北武汉430030

出　　处：《中国法医学杂志》2009年第5期304-308,共5页Chinese Journal of Forensic Medicine

摘　　要：目的探讨重型颅脑损伤患者视觉和听觉P300的特征及与智商的相关性和其应用价值。方法采用中国修订韦氏成人智力量表与Neuroscan-ERP仪对29名重型颅脑损伤患者(外伤组)和46名健康志愿者(对照组)进行智测及视觉、听觉P300检测,分析其特征和相关性。结果外伤组智商均值明显低于对照组(P<0.01);视觉P300包括P2、N2和P3成分,听觉P300包括N1、P2、N2、P3成分。外伤组P300波形分化不良,视觉P300各成分的波幅和潜伏期均较对照组明显降低和延长(P<0.05);听觉P300的P2波幅和N2、P3的波幅及潜伏期也明显降低和延长(P<0.05)。视觉和听觉P300各成分中仅P3潜伏期与总智商呈负相关(r=-0.30^-0.42,P<0.05)。结论重型颅脑损伤患者治疗终结后智能仍明显下降,视觉和听觉P300的波幅和潜伏期亦明显异常,且P3潜伏期与智商呈负相关,可作为评估智能损害的一项神经电生理参考指标。Objective To investigate the features of P300 elicited by visual and auditory stimulus, and evaluate the correlations between intelligence quotient and the components of P300 in patients with severe traumatic brain injury （sTBI）. Methods P300 values were recorded in 29 patients with intelligence impairment induced by sTBI and in 46 healthy controls while they were asked to performance on visual and auditory Oddball task. Intelligence quotient （IQ） was measured using the Weehsler Adult Intelligence Scale-Revised in China （WAIS-RC）. Results The patients＇ scores of all sub-tests and mean IQ were significantly lower than those of the controls （P 〈0.01 ）. In two groups, the components of visual P300 included P2, N2 and P3, and auditory P300 included N1, P2, N2 and P3. The visual and auditory 1o300 waveform, from the group of sTBI patients, had more variation and artifacts than those of the controls. The mean latency and amplitude of visual P300 waveform in sTBI patients were significantly longer and lower as compared to control group （P 〈 0.05 ）. The amplitude of the P2 component and both the amplitude and latency of the N2 and P3 components , of the auditory P300 waveform, were also lower and longer than those of the controls （P 〈 0.05 ）. The latency of visual and auditory P3 had significantly negative correlation with FIQ of WAIS-RC in controls and sTBI patients （ r = - 0.30 N - 0.42, P 〈 0. 05 ）. Conclusion The pa- tients of sTBI had significant intelligence impairment, the variation of the latency and amplitude of P300 were sensitive to the cognitive defcits. Moreover, the latency of P3 correlates well with IQ, and thus the latter may be an objective electrophysiological index for assessing the severity of intelligence impairment induced by sTBI.

关 键 词：法医临床学 重型颅脑损伤 智商 事件相关电位 视觉听觉刺激 

分 类 号：D919[医药卫生—法医学]