脑微出血患者风险决策受损  

Impaired risk decision in patients with cerebral microbleeds

作　　者：谢飞[1] 刘秋皖 王娟[1] 汪凯[2] 吴君仓[1] 

机构地区：[1]合肥市第二人民医院广德路院区神经内科,230011 [2]安徽医科大学附属医院神经内科,合肥230022

出　　处：《国际脑血管病杂志》2016年第10期887-891,共5页International Journal of Cerebrovascular Diseases

基　　金：合肥市第二人民医院光华基金（院科教[2016]98号）

摘　　要：目的探讨脑微出血（cerebralmicrobleeds，CMBs）患者在风险概率明确的条件下决策能力是否受损。方法采用风险概率明确的骰子博弈测试（GameofDiceTest，GDT）对45例CMBs患者和45名非CMBs患者进行风险决策能力研究。结果GDT表明，CMBs组受试者与非CMBs组相比更偏爱选择风险选项[（9．64±3．22）次对（6．51±4．48）次；t=3．809，P〈0．001]。在4个选项中，CMBs组选择最多的是风险最高的选项即2个数字[（6．91±3．02）次对（4．71±2．95）次；t=3．494，P=0．001]，而非CMBs组选择最多的是3个数字[（4．87±2．17）次对（7．71±2．71）次；t=-5．496，P〈0．001]。将整个GDT分为3个阶段，所有3个阶段CMBs组选择安全选项的次数均显著少于非CMBs组[第1阶段：（-0．27±3．00）次对（0．93±3．09）次；t=-1．867，P=0．065；第2阶段：（-0．62±2．55）次对（2．27±2．65）次；t=-5．268，P〈0．001；第3阶段：（-0．53±2．57）次对（2．89±3．12）次；t=-5．677，P〈0．001]；而且，随着实验选择次数的增加，非CMBs组选择安全选项逐渐增多（F=4．780，P=0．010），而CMBs组则不然（F=0．209，P=0．812）。结论CMBs患者在风险概率明确条件下存在明显的决策能力受损。Objective To investigate whether the decision-making ability was impaired under the condition of clear risk probability in patients with cerebral miceobleeds （CMBs）. Methods The Game of Dice Test （GDT） with the clear risk probability was used to conduct the risk decision ability study in 45 patients with CMBs and 45 without CMBs. Results GDT showed that patients in the CMBs group was more like to choose the risky option compared with the non-CMB group （9. 64 ± 3.22 vs. 6. 51 ±4. 48; t =3.809, P 〈0. 001）. Among the 4 options, the most frequent choice in the CMBs group was the option of the highest risk, i.e. 2 numbers （6. 91 ±3.02 vs. 4. 71±2. 95; t =3.494, P=0. 001）; and the most frequent choice in the non-CMBs was 3 numbers （4.87 ±2. 17 vs. 7. 71 ±2.71; t = -5. 496, P〈0. 001）. The GDT was divided into 3 stages. The number of security options selected by patients in the CMBs group was significantly less than that by patients in the non-CMBs group in all stages （stage 1：-0.27 ±3.00 vs. 0.93 ±3.09;t= -1.867, P=0.065;stage2：-0.62±2.55 vs. 2.27 ±2.65;t= -5.268, P〈 0. 001; stage 3： -0.53 ± 2.57 vs. 2.89 ± 3.12; t = -5. 677, P 〈 0. 001）, and with the increase of the number of tests, selecting security options increased gradually in the non-CMB group （F = 4. 780,P = 0. 010）, while the CMBs group was not （F= 0. 209, P = 0. 812）. Conclusions The patients with CMBs have significant impairment in decision making ability under the condition of specific risk probability.

关 键 词：脑出血 磁共振成像 认知障碍 决策 赌博 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]