酒精性精神障碍患者额叶执行功能变化及其临床意义  

Changes of executive function of frontal lobe in patients with alcohol-induced mental disorders

作　　者：钱卫娟[1] 刘刚[1] 任方芳[1] 赵月秋[2] QIAN Weijuan;LIU Gang;REN Fangfang;ZHAO Yueqiu(Nanfing Brain Hospital Affiliated to Nanfing Medical University, Nanfing 210029, China)

机构地区：[1]南京医科大学附属脑科医院,南京210029 [2]江苏联合职业技术学院南京卫生分院

出　　处：《山东医药》2018年第20期13-16,共4页Shandong Medical Journal

基　　金：南京市医学科技发展项目(YKK10120)

摘　　要：目的探讨酒精性精神障碍患者额叶执行功能变化及其临床意义。方法选择酒精性精神障碍患者28例作为观察组,同期另选体检健康者30例作为对照组。观察组入院后均戒酒,如出现戒断反应,给予氯硝西泮等对症支持治疗,疗程7~10天。观察组入院时及治疗后1个月、对照组入组第2天行事件诱发电位(P300)检测及威斯康星卡片分类测验(WCST),记录P300靶刺激N1、P2、N2、P3的潜伏期及波幅,WCST相关参数完成分类数(Cc)、错误应答数(Re)、持续性应答(Rp)、持续性错误(Rpe)及概念化水平(Cl%)。分析观察组治疗前后WCST各参数减分值与P300相关参数的关系。结果观察组靶刺激N2、P3的潜伏期长于对照组,靶刺激N1、N2、P3的波幅低于对照组(P<0.05或<0.01);观察组治疗前Cc、Cl%明显低于对照组,Re、Rp、Rpe均明显高于对照组(P均<0.01);治疗后1个月Cc、Cl%均明显高于治疗前,Re明显低于治疗前(P均<0.05)。观察组治疗后1个月Cc、Rp、Rpe高于对照组,Cl%低于对照组(P<0.05或<0.01)。观察组WCST相关参数中Rp、Rpe减分值均与P300靶刺激N1潜伏期呈正相关关系(r分别为0.591、0.616,P<0.05),Cl%减分值与P300靶刺激N2潜伏期呈正相关关系(r=0.581,P<0.05)。观察组治疗前后WCST各参数减分值与P300靶刺激N1、P2、N2、P3波幅均无明显相关性(P均>0.05)。结论酒精性精神障碍患者存在额叶执行功能损害;该损害具有一定可逆性,早期干预治疗对于减轻其额叶执行功能损害具有重要意义。Objective To observe changes of the executive function of frontal lobe in patients with alcohol-induced mental disorders and to explore its clinical significance. Methods Twenty-eight patients with alcohol-induced mental disorders were selected as the observation group,and thirty healthy volunteers in the outpatient physical examination of the same hospital were selected as the control group during the same period. All patients in the observation groups were abstaining from alcohol after admission,in the case of withdrawal syndrome,the clonazepam was given for 7 to 10 days. The patients in the control group underwent event-related potentials（P300） and Wisconsin card sorting test（WCST） on the second day,and patients in the observation group received P300 and WCST on admission and at 1 month after treatment; the latency and amplitude of N1,P2,N2,P3 in P300 and the complete classification number（Cc）,error response（Re）,continuous response（Rp）,constant error（Rpe） and conceptual level（Cl%） of WCST related parameters were recorded.The correlation of the subtraction of WCST parameters before and after treatment with P300 parameters was analyzed. Results The latency of N2 and P3 in the observation group was significantly longer than that of the control group,and the wave amplitude of N1,N2,P3 of observation group was significantly lower than that of the control group（P〈0. 05 or P〈0. 01）. Before the treatment,Cc and Cl% in the WCST of the observation group were significantly lower than those of the control group,while Re,Rp and Rpe were significantly higher than those of the control group（all P〈0. 01）. After onemonth treatment,Cc and Cl% of the observation group were significantly higher,and Re was significantly lower than those before treatment（all P〈0. 05）. After one-month treatment,Cc,Rp,and Rpe of the observation group were significantly higher than those of the control group,while Cl% was significantly lower than that of the control group（P〈0. 05 or0. 01）. In obser

关 键 词：酒精性精神障碍 事件诱发电位 威斯康星卡片分类测验 额叶 执行功能 

分 类 号：R749.6[医药卫生—神经病学与精神病学]