脑梗死向血管性痴呆转归患者脑电图改变的观察  

Characteristics of electroencephalograph in cerebral infarction patients with subsequent vascular dementia

作　　者：罗伏钢[1] 沈志华[2] 黄悦琦 章晓英[3] 陈梅芳[1] Luo FG;Huang YQ;Chen MF;Shen ZH;Zhang XY(Department of Geriatrics, the Hangzhou Seventh Hospital, Hangzhou 310007, China;Department of Electroencephalograph, the Hangzhou Seventh Hospital, Hangzhou 310007, China;Department of Neurology, the Hangzhou Seventh Hospital, Hangzhou 310007, China)

机构地区：[1]杭州市第七人民医院老年科,310007 [2]杭州市第七人民医院脑电图室,310007 [3]杭州市第七人民医院神经内科,310007

出　　处：《中华全科医师杂志》2018年第2期136-139,共4页Chinese Journal of General Practitioners

基　　金：杭州市科技发展计划项目（20150633810）

摘　　要：对2015—2016年在我院诊治的72例脑梗死（额或颞或额颞叶）急性期患者脑电图检查资料行回顾性分析，其中65例随访至患病后6个月，34例诊断为血管性痴呆（VD）（VD组），31例为单纯脑梗死（对照组）。入院时（门诊就诊至入院后3 d内且患病1周内）VD组脑电图异常率高于对照组（χ2＝5.44，P＝0.02）；与对照组相比，VD组入院时、患病后3和6个月的慢波（θ和δ波）功率均显著增高，差异有统计学意义（θ波：F组间＝17.39，F组内＝163.50，F交互＝38.71，均P＝0.00；δ波：F组间＝5.10，F组内＝119.04，F交互＝6.54，均P〈0.05）。VD组α和β波功率随时间减低，差异有统计学意义（α波：F＝116.40，P＝0.00；β波：F＝55.90，P〈0.05）。与对照组相比，VD组θ波平均功率除额叶入院时和患病3个月时均存在显著增高（均P〈0.05）；且各时间点额、顶叶及中央区δ波平均功率均显著增高（均P〈0.05）。除枕叶θ波外的所有脑区慢波平均功率各时间点比较差异有统计学意义（P〈0.05）。提示脑梗死转归为VD患者脑电图有慢波增多的改变，可能对早期识别有提示意义。Clinical data of 65 patients with acute cerebral infarction （frontal or temporal or both lobes） treated in our hospital during 2015—2016 were retrospectively reviewed.The patients were followed up for 6 months, 34 cases were diagnosed as vascular dementia （VD） according to ICD-10 （VD group） and 31 cases were diagnosed as simple cerebral infarction （control group）. The abnormal rate of electroencephalograph （EEG） at baseline in VD group was significantly higher than that in control group （χ2=5.44, P=0.02）. Compared to control group, the powers of slow wave （θ wave and δ wave） at baseline, third month and sixth month in VD group were significantly increased （Fbetween groups=17.39, Finner groups=163.50, Finteraction=38.71; all P=0.00） and （Fbetween groups=5.10, Finner groups=119.04, Finteraction=6.54; P〈0.05）. Compared to baseline, the α wave and β wave were significantly decreased at third month and sixth month in VD （Finner groups=116.40, P=0.00） and （Finner groups=55.90, P〈0.05）. Compared to control group, the powers of θ wave （except in the frontal lobe at baseline and third month） and δ wave were significantly increased at all time points （P〈0.05）. Except the θ wave in occipital lobe, there were significant differences in slow wave at all time points between VD group and control group （P〈0.05）. The featured EEG with increased slow wave in many regions of cerebral infarction can be used for early diagnosis of VD in patients with cerebral infarction.

关 键 词：血管性痴呆 脑梗死 脑电图 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R749.13[医药卫生—临床医学]