事件相关电位P300在脑卒中后认知障碍中的诊断价值  

The value of event-related potential P300 for diagnosing cognitive impairment after stroke

作　　者：郭静 彭宇[1] 靳娇婷[2] 胡芳芳[2] 乔晋[1] Guo Jing;Peng Yu;Jin Jiaoting;Hu Fangfang;Qiao Jin(Department of Rehabilitation Medicine,The First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Department of Neurology,The First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China)

机构地区：[1]西安交通大学第一附属医院康复医学科,西安710061 [2]西安交通大学第一附属医院神经内科,西安710061

出　　处：《中华物理医学与康复杂志》2022年第7期610-614,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察事件相关电位P300对脑卒中后认知障碍(PSCI)的诊断意义。方法纳入符合条件的PSCI高危患者49例作为观察组,另选54例健康志愿者作为对照组,收集所有研究对象的一般临床资料和蒙特利尔认知评估量表(MoCA)评分,比较2组P300潜伏期、波幅及按键反应的平均时间(MRT)。以MoCA量表总分<26分(文化程度≤12年,总分加1分,校正受教育程度偏倚)作为认知障碍的诊断标准,受试者操作特性曲线(ROC)用于分析P300对卒中后认知障碍的诊断效能,并确定诊断界值。结果①观察组和对照组的MoCA评分总分分别为(17.06±6.05)和(26.41±2.80)分,P300潜伏期分别为(403.51±34.89)和(344.52±48.71)ms,P300 MRT分别为(558.70±133.33)和(466.73±101.66)ms,2组间差异均有统计学意义(P<0.01);P300波幅中位数分别为2.60μV、2.10μV,组间差异无统计学意义(P>0.05);②以MoCA总分<26分作为评价认知障碍的标准进行ROC曲线分析,P300潜伏期的诊断界值为376.50 ms,曲线下面积0.795,敏感性为70.8%,特异性为78.9%;P300 MRT的诊断界值为423.35 ms,曲线下面积0.695,敏感性80.0%,特异性52.6%。结论事件相关电位P300可用于PSCI的诊断,P300潜伏期特异度及灵敏度均较好,具有较好的诊断效能。Objective To observe the utility of event-related potential P300 in diagnosing post-stroke cognitive impairment.Methods Forty-nine stroke survivors at high risk of cognitive impairment formed the observation group,while 54 healthy volunteers were the control group.General clinical data and Montreal Cognitive Assessment Scale(MoCA)scores were compiled for all of the subjects,and the two groups′P300 latencies,amplitudes and mean reaction times(MRTs)were compared.A total MoCA score<26(corrected for education level)was taken as the diagnostic criterion for cognitive impairment.The receiver operating characteristics(ROC)curve was employed to analyze the diagnostic efficacy of P300 for post-stroke cognitive impairment and determine the diagnostic cutoff.Results(1)The average MoCA score,P300 latency and P300 MRT of the observation group were all significantly different from the control group′s averages.There was,however,no significant difference between the two groups′median P300 amplitudes.(2)According to the ROC curve analysis,the diagnostic limit of P300 latency was 376.50ms.With the area under the curve 0.795,sensitivity was 70.8%and specificity was 78.9%.The diagnosis cut-off value of P300 MRT was 423.35ms,with the area under the curve 0.695,giving a sensitivity of 80.0%and a specificity of 52.6%.Conclusions Event-related potential P300 has useful efficacy in diagnosing post-stroke cognitive impairment.

关 键 词：事件相关电位 P300 认知功能障碍 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]