糖尿病及糖尿病并发脑缺血性病变患者听觉事件相关电位P300的改变  

Changes in P300 in type 2 diabetic patients with versus without cerebral ischemia

作　　者：王亭亭[1] 贾志荣[1] 潘涛[1] 王洪霞[1] 石盺 梁为[1] 

机构地区：[1]北京大学第一医院神经内科,北京100034

出　　处：《中国糖尿病杂志》2012年第1期28-30,共3页Chinese Journal of Diabetes

摘　　要：目的应用神经电生理方法,探讨T2DM伴与不伴脑缺血性病变患者认知功能的改变。方法 62例中老年T2DM患者,根据头MRI检查有无缺血病灶,将其分为单纯糖尿病组(DM组,n=35例)和糖尿病合并脑缺血性病变组(DM+CI组,n=27例)。两组患者和正常对照组(NC组,30名)均进行听觉事件相关电位P300检查。结果 DM组及DM+CI组的P300潜伏期均较NC组明显延长(P<0.01);DM组及DM+CI组的P300波幅较NC组明显降低(P<0.01)。DM+CI组的P300波幅较DM组降低(P<0.01),前者潜伏期延长,但差异无统计学意义(P>0.05)。多种因素分析,脑缺血对P300潜伏期影响最大。DM组病程与P300波幅呈负相关(P<0.05),DM组病程和P300潜伏期呈正相关(P<0.05)。结论 T2DM可引起患者认知功能损害,合并缺血性脑损害可加重患者的认知功能损害,事件相关电位P300检测可作为老年糖尿病认知损害早期诊断的客观指标。Objective To investigate the cognitive function in elderly type 2 diabetic patients with versus without cerebral ischemia.Methods 62 patients with type 2 diabetes mellitus（DM） were divided into DM with cerebral ischemia（CI）group（35 cases）and DM without cerebral ischemia group（35 cases） by CT scan.Audio event-related potentials（P300） was measured in above groups and 30 matched normal control.The latency period（Lat） and the amplitude（Amp） were detected.Results The average Lat of P300 in DM without CI was（388.17±39.2）ms while that in DM with CI was（400.27±52.32）ms,which was longer than in normal control group（359.27±37.16）ms（P〈0.01）.The average Amp of P300 in DM[（7.2±3.95）mV]and DM with CI[（5.83±2.31）mV]was lower than the normal control group[（7.84±3.57）mV]（P〈0.01）.The Amp was longer in DM with CI than in DM（P〈0.01）.Multivariate analysis showed that cerebral ischemia influenced the latency period of P300 at most.There was a negative correlation between the course of the DM and the amplitude of P300（P〈0.05）,while there was a positive correlation between the course of DM and the latency of P300（P〈0.05）. Conclusions The type 2 diabetic patients have cognitive impairment,and cerebral ischemia may exacerbate the cognitive impairment.P300 can be a sensitive index in early diagnosis and dynamic monitoring of cognitive impairment in elderly individuals with type 2 diabetes.

关 键 词：糖尿病 2型 脑缺血 认知障碍 P300 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]