意识障碍患者的床旁脑电测试与功能恢复预后研究  

Study on the prognosis and functional recovery of patients with disorder of consciousness by bedside electroencephalogram test

作　　者：徐珑[1,2] 王波[3] 王泳[4] 赵继宗[1,2] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050 [2]首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心,北京100050 [3]中国科学院生物物理研究所脑与认知科学国家重点实验室,北京100101 [4]首都医科大学附属复兴医院高压氧科,北京100038

出　　处：《科技导报》2017年第4期68-73,共6页Science & Technology Review

基　　金：国家重点基础研究发展计划(973计划)项目(2012CB825505)

摘　　要：针对意识障碍患者残余脑功能的检测和预后相关性研究是重要的科学问题。本文探讨了事件相关电位中的失匹配负波(MMN)在预测重症颅脑损伤后意识障碍(DOC)患者意识恢复及远期预后中的临床价值。通过对6例重症颅脑损伤后意识障碍患者进行MMN检测,之后长期随访其意识水平变化,对其临床资料进行回顾性分析。微意识状态(MCS)较植物状态(VS)患者出现MMN的可能性更大,而出现MMN的微意识状态患者远期较恢复意识的可能性更大,未出现MMN的植物状态患者恢复意识可能性最小。因此,作为事件诱发脑电的经典范式,MMN有可能预测意识障碍患者意识恢复,并与长期预后相关。The relationship between the testing results of remnant functions of patients with consciousness disorder and their prognosis is an important issue. Our study focuses on the clinical value of the mismatch negativity（MMN） applied for predicting the consciousness recovery and the long-term prognosis of severe traumatic brain injury patients. A retrospective research considers 6 cases of DOC, induced by severe brain injury. The Mismatch Negativity（MMN） is tested and the long- term follow- up is made to record the variation of consciousness. A higher incidence rate of the MMN can be observed in MCS cases than in VS cases. In the long-term recovery, the MCS cases with MMN have more possibility of recovering to consciousness, but not the VS cases without MMN. Thus, as one of classical protocols of the event related potential（ERP）, the MMN might be a method for predicting the consciousness recovery in the DOC cases,related with their prognosis.

关 键 词：意识障碍 植物状态 微意识状态 预后 失匹配负波 

分 类 号：R749[医药卫生—神经病学与精神病学]