腔隙性脑梗死患者认知功能与脑事件相关电位的关系  

Relationship between cognitive function and brain event-related potentials in patients with lacunar cerebral infarction

作　　者：张萍淑[1] 郑慧 徐斌[1] 李鑫 王卓[3] 赵艳生[3] 元小冬[1] Zhang Pingshu;Zheng Hui;Xu Bin;Li Xin;Wang Zhuo;Zhao Yansheng;Yuan Xiaodong(Department of Neurology,Kailuan General Hospital,Tangshan 063000,China;Key Laboratory of Neurobiological Function of Hebei Province,Tangshan 063000,China;Department of Magnetic Resonance Imaging,Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院神经内科,唐山063000 [2]河北省神经生物机能重点实验室,唐山063000 [3]开滦总医院核磁共振室,唐山063000

出　　处：《中国综合临床》2022年第2期114-122,共9页Clinical Medicine of China

基　　金：河北省重点研发计划项目(203777116D);河北省医学科学研究课题计划(20201283);唐山市科学技术研究与发展计划(19150256E)。

摘　　要：目的探讨腔隙性脑梗死患者认知功能与脑事件相关电位的关系。方法连续收集2014—2019年就诊于开滦总医院神经内科的腔隙性脑梗死患者464例作为观察对象(病例组),进行前瞻性队列研究。病例组依据简易智能精神状态(mini-mental state examination,MMSE)评分分为认知正常组352例和轻度认知障碍组112例。同时选取同期100名健康体检志愿者为对照组。对所有研究对象进行简易智能精神状态、宗氏焦虑、宗氏抑郁量表测评和脑事件相关电位P3a和P3b检测。正态分布的计量资料采用单因素方差分析,非正态分布的计量资料采用Kruskal-WallisH检验,计数资料采用χ^(2)检验,非条件Logistics(逐步法)进行多因素统计学分析。结果对照组、认知正常组、轻度认知障碍组占比吸烟者分别为20.00%(20/100)、38.07%(134/352)、46.42%(52/112);饮酒者分别为18.00%(18/100)、33.24%(117/352)、33.93%(38/112);高血压分别为38.00%(38/100)、58.24%(205/352)、59.82%(67/112);高同型半胱氨酸血症分别为19.00%(19/100)、34.00%(120/352)、68.75%(77/112),3组间比较差异均有统计学意义(χ^(2)值分别为15.66、7.91、11.86、54.57,P<0.001、P=0.019、P=0.003、P<0.001)。3组视觉P3b波群N2峰潜伏期CZ导联分别为(271.48±40.65)、(285.67±44.08)、(290.57±68.41)ms,PZ导联分别为(276.70±50.92)、(287.86±43.28)、(312.16±62.75)ms;P3b峰潜伏期FZ导联分别为(392.67±42.50)、(405.82±52.43)、(410.34±64.27)ms,CZ导联分别为(395.04±42.44)、(412.51±55.86)、(433.28±66.32)ms,PZ导联分别为(398.24±40.93)、(411.17±49.48)、(435.78±67.69)ms;N2波幅CZ导联分别为(-3.99±2.81)、(-3.60±3.00)、(-2.70±2.37)μV,PZ导联分别为(-3.18±2.69)、(-2.91±2.62)、(-1.87±2.89)μV;P3b波幅FZ导联分别为5.27(3.27,7.40)、4.21(2.31,6.49)、3.12(1.61,5.08)μV,CZ导联分别为4.81(2.78,6.71)、4.15(2.76,6.16)、3.51(1.75,5.15)μV,PZ导联分别为5.17(3.03,6.97)、4.40(2.89,6.12)、3.43(1.52,5.34)μV,3组间比�Objective To investigate the relationship between cognitive function and brain event-related potential in patients with lacunar cerebral infarction.Methods A total of 464 patients with lacunar cerebral infarction admitted to the Department of Neurology,Kailuan General Hospital from 2014 to 2019 were prospectively selected as observation subjects(case group).According to mini-mental state examination(MMSE)score,the patients in the case group were divided into 352 cases of lacunar cerebral infarction with normal cognition and 112 cases of mild cognitive impairment.At the same time,100 healthy volunteers were selected as the control group.All subjects were assessed by simple intelligent mental state,Zung self-rating anxiety scale,Zung self-rating depression scale and brain event-related potential P3a and P3b.The measurement data of normal distribution adopts one-way ANOVA,the measurement data of non normal distribution adopts Kruskal Wallis H test,and the counting data adoptsχ^(2).Multivariate statistical analysis was performed by unconditional Logistics(stepwise method).Results The proportions of smokers in control group,lacunar cerebral infarction cognitive normal group and lacunar cerebral infarction mild cognitive impairment group were 20.00%(20/100),38.07%(134/352)and 46.42%(52/112),respectively.The proportions of drinkers were 18.00%(18/100),33.24%(117/352),33.93%(38/112),respectively.The proportions of hypertension were 38.00%(38/100),58.24%(205/352),59.82%(67/112),respectively.The proportions of hyperhomocysteinemia were 19.00%(19/100),34.00%(120/352)and 68.75%(77/112),respectively,and the differences among the three groups were statistically significant(χ^(2) values were 15.66,7.91,11.86 and 54.57,respectively;P<0.001,0.019,0.003,<0.001).The peak latency CZ leads of visual P3b wave group N2 were(271.48±40.65),(285.67±44.08)and(290.57±68.41)ms,respectively.PZ leads were(276.70±50.92),(287.86±43.28)and(312.16±62.75)ms.P3b peak latency FZ leads were(392.67±42.50),(405.82±52.43)and(410.34±64.27)ms.CZ

关 键 词：腔隙性脑梗死 认知功能 事件相关电位 P3B P3A 

分 类 号：R743.33[医药卫生—神经病学与精神病学]