P300评定卒中后抑郁患者认知功能对照研究的Meta分析  

The study of P300 on patients with post-stroke depression:a systematic review and Meta-analysis

作　　者：李荣华[1] 杨勇[2,1] 冯秀娟[1] 袁颖[1] 杜向东[1] 杨晔琴[3] 

机构地区：[1]苏州大学附属广济医院临床精神科,215008 [2]苏州大学附属第一医院精神科 [3]温州医学院护理学院

出　　处：《四川精神卫生》2012年第2期80-85,共6页Sichuan Mental Health

基　　金：苏州市科技计划项目(SYS2010057)

摘　　要：目的系统评价事件相关电位P300评定卒中后抑郁(post-stroke depression,PSD)患者认知功能的价值。方法采用STATA11.0软件对国内有关卒中后抑郁(PSD)患者事件相关电位P300的临床研究进行Meta分析。结果共纳入7项符合条件的病例对照研究,共907例研究对象,均包括卒中后抑郁组(PSD组,n=422),另对照组包括卒中无抑郁组(N-PSD组,n=265)和/或正常对照组(NC组,n=220),评价各组之间比较存在异质性,采用随机效应模型进行综合检验,结果为:①P300波幅:4项研究比较了PSD组与NC组P300波幅变化,结果显示PSD组较NC组P300波幅降低明显,差异具有显著统计学意义[OR=-3.56,95%CI(-5.71,-1.40),P=0.001]。6项研究比较了PSD组与N-PSD组P300波幅变化,结果显示PSD组较N-PSD组P300波幅降低明显,差异具有显著统计学意义[OR=-2.17,95%CI(-3.25,-1.09),P=0.000]。3项研究比较了N-PSD组与NC组P300波幅变化,结果显示N-PSD组较NC组P300波幅降低,差异具有统计学意义[OR=1.92,95%CI(0.34,3.49),P=0.017];②P300潜伏期:4项研究同时报道了PSD组与NC组P300潜伏期变化,结果显示PSD组较NC组P300潜伏期明显延长,差异具有显著统计学意义[OR=42.90,95%CI(26.58,59.21),P=0.000]。6项研究同时报道了PSD组与N-PSD组P300潜伏期变化,结果显示PSD较N-PSD组P300潜伏期明显延长,差异具有显著统计学意义[OR=27.02,95%CI(15.89,38.15),P=0.000]。3项研究同时报道了N-PSD组与NC组P300潜伏期变化,结果显示N-PSD组较NC组P300潜伏期延长,差异具有显著统计学意义[OR=-17.67,95%CI(-23.64,-11.70),P=0.000]。结论目前研究表明,与卒中后无抑郁患者及正常人相比,卒中后抑郁患者P300波幅显著降低、潜伏期明显延长;P300检测可为筛查卒中后抑郁患者早期认知功能损害的辅助指标。Objective To evaluate the cognitive function of patients with post-stroke depression（PSD）by studying the value of that event-related potential P300 using meta-analysis and systematic review. Methods Meta analyses were applied to the domestic case-control studies of event related potential P300 for the patients with PSD using the software STATA 11.0. Results A total 7 clinical control trials with 907 cases are accepted,which include post-stroke depression group（PSD group,n=422） and post-stroke patients without depression（N-PSD group,n=265） and/or normal control group（NC group,n=220）,for evaluating the heterogeneity between those groups and testing with Random Effects Model.Amplitudes of P300：the changes of amplitudes between PSD group and NC group are compared in 4 studies,showing the amplitudes in PSD group lower than that in NC group with statistical significance[OR=-3.56,95%CI（-5.71,-1.40）,P=0.001].While compared between PSD group and N PSD group in 6 studies,the amplitudes in PSD group are lower than that in N-PSD group with statistical significance[OR=-2.17,95%CI（-3.25,-1.09）,P=0.000].The amplitudes of N-PSD group are lower than that in NC group in 3 studies between the two groups with statistical significance[OR=1.92,95%CI（0.34,3.49）,P=0.017].Latencies of P300：the changes of latencies between PSD group and NC group were reported in 4 studies,suggesting latencies in PSD group is significantly longer than that in NC group[OR=42.90,95%CI（26.58,59.21）,P=0.000].The changes between PSD group and N-PSD group in 6 studies are reported with the latencies in PSD group is significantly longer than that in N-PSD group[OR=27.02,95%CI（15.89,38.15）,P=0.000].The latencies of N-PSD group are significantly longer than NC group while compared between the two groups in 3 studies[OR=-17.67,95%CI（-23.64,-11.70）,P=0.000]. Conclusion The evidence in those studies reveals longer latencies and lower amplitudes of P300 in the patients of PSD can be applicable to evaluate the cognitive functi

关 键 词：卒中后抑郁 事件相关电位 认知电位 P300 META 分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学]