双相障碍抑郁发作患者认知功能损害及与听觉P300改变的关系  

Study on the relationship between cognitive impairment and P300 in patients with depressive episode of bipolar disorder

作　　者：文万军 陈晔 覃宗厚 张程赪 吴伟娟 徐志阳 李鹏 叶蕾 张毅[2] 张晨[2] WEN Wan-jun;CHEN Ye;QIN Zong-hou;ZHANG Cheng-cheng;WU Wei-juan;XU Zhi-yang;LI Peng;YE Lei;ZHANG Yi;ZHANG Chen(the Third People's Hospital of Yuebei,Shaoguan 512200,China)

机构地区：[1]广东省韶关市粤北第三人民医院,512200 [2]上海交通大学医学院附属精神卫生中心

出　　处：《临床精神医学杂志》2022年第1期43-45,共3页Journal of Clinical Psychiatry

基　　金：韶关市科技计划项目(Y20003)。

摘　　要：目的:探讨双相障碍抑郁发作患者认知功能损害和听觉P300变化的关系。方法:采用重复性神经心理状态测验(RBANS)及听觉诱发电位检测方法对43例首次发病未服药的双相障碍抑郁发作患者(病例组)及45名健康志愿者(对照组)进行认知功能及P300指标检测;结果进行组间比较和分析。采用汉密尔顿抑郁量表(HAMD)评估病例组患者的临床症状;采用相关性及多元线性逐步回归分析患者认知功能损害和听觉P300变化的关系。结果:两组RBANS各因子分及总分差异具有统计学意义(P均<0.01)。病例组P300潜伏期显著长于对照组,波幅显著低于对照组(P均<0.01)。相关性分析显示病例组P300潜伏期与RBANS注意因子分和总分呈负相关(r=-0.42,P=0.006;r=-0.32,P=0.034);P300波幅与RBANS即刻记忆因子分呈正相关(r=0.34,P=0.026)。多元线性逐步回归分析显示RBANS总分与P300潜伏期呈负相关(t=-2.76,P=0.009)。结论:双相障碍抑郁发作患者P300指标异常可反映其认知功能损害程度。Objective:To investigate the relationship between auditory P300 and cognitive impairment in patients with depressive episode of bipolar disorder.Method:43 patients with depressive episode of bipolar disorder(case group)and 45 healthy volunteers(control group)were enrolled to detect their cognitive function and P300 index by Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and auditory evoked potentials test.Hamilton Depression Scale(HAMD)was used to evaluate the clinical symptoms of patients in the case group.Correlation and multiple linear stepwise regression analyses were used to analyze the relationship between cognitive impairment and auditory P300.Results:The total score and subscores of RBANS had statistically significant differences in the two groups(all P<0.01).P300 latency in the case group was significantly longer than that in the control group,and its amplitude was significantly lower than that in the control group(both P<0.01).Correlation analysis showed that P300 latency was negatively correlated with RBANS attention and total scores(r=-0.42,P=0.006;r=-0.32,P=0.034);P300 amplitude was positively correlated with RBANS immediate memory scores(r=0.34,P=0.026).Multiple linear stepwise regression analysis showed a negative correlation between RBANS total scores and P300 latency(t=-2.76,P=0.009).Conclusion:Abnormal P300 index may reflect the severity of cognitive impairment in patients with depressive episode of bipolar disorder.

关 键 词：双相障碍 抑郁发作 P300 认知功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]