慢性意识障碍患者昏迷恢复量表与事件相关电位的相关性分析  

Correlation analysis between coma recovery scale and event-related potential in patients with prolonged disorders of consciousness

作　　者：董艺 谭浩[2] 陶希 宋涛[1] DONG Yi;TAN Hao;TAO Xi(The First Affiliated Hospital of Hunan Normal University,Hunan Provincial People's Hospital,Changsha,410016)

机构地区：[1]湖南师范大学第一附属医院,湖南省人民医院康复医学科,湖南省脑血管病康复临床医学研究中心,湖南省长沙市410016 [2]湖南省人民医院中西医结合科

出　　处：《中国康复医学杂志》2024年第5期663-668,共6页Chinese Journal of Rehabilitation Medicine

基　　金：长沙市科技局科研项目(kq2004122)。

摘　　要：目的:探讨慢性意识障碍患者昏迷恢复量表(CRS-R)与事件相关电位MMN、P300的相关性,从而确立CRS-R量表联合事件相关电位评估慢性意识障碍患者意识水平的临床价值。方法:按照入选标准纳入意识障碍患者61例,所有纳入患者在同一时间段(即72h内)完成CRS-R评定及事件相关电位(MMN和P300)检查。先对所收集的数据行正态性检验,符合正态分布的数据采用Pearson相关性分析,不符合正态分布的数据采用Spearman相关性分析,然后将具有相关性的两组数据在考虑年龄、性别、病程、病因、BMI、意识水平等多因素响的情况下进行线性回归多因素分析。结果:在考虑年龄、性别、病程、病因、BMI、意识水平等混杂因素的情况下,CRS-R(听觉)与MMN(F4潜伏期)、CRSR(视觉)与MMN(CZ波幅)、MMN(FZ波幅)、MMN(F3波幅),CRS-R(运动)与MMN(CZ波幅)和MMN(F4波幅),CRS-R(唤醒度)与MMN(F4潜伏期),CRS-R(总分)与MMN(CZ波幅)存在相关性,其中CZ(波幅)与CRS-R(运动)相关系数为0.759、F4(波幅)与CRS-R(运动)相关系数为0.689、FZ(波幅)与CRSR(视觉)相关系数为0.685,为显著相关。而CRS-R(听觉)与P300(F3波幅)、CRS-R(视觉)与P300(CZ波幅)、CRS-R(口部运动)与P300(F4潜伏期、FZ潜伏期)均存在相关性。结论:CRS-R量表各评分项目与MMN、P300电极点的波幅、潜伏期存在相关性,为慢性意识障碍的临床行为学评估提供电生理检测的客观、直接证据。Objective:To explore the correlation between coma recovery scale(CRS-R)and event-related potential MMN and P300 in patients with prolonged disorders of consciousness,thereby establishing the clinical value of CRS-R scale combined with event-related potential in assessing the level of consciousness in these patients.Method:Sixty-one patients with disturbance of consciousness were enrolled according to the inclusion criteria,and all patients completed the CRS-R assessment and event-related potential(MMN and P300)within the same time period(72 hours).The data olected were first subiccted to a normality test,and the data with normal distribution were examined by pearson correlation analysis,while the data that did not fit a normnal dis-tribution were analyzed using spearman correlation.Then,the two sets of data that showed corrclation were fur-ther analyzed using multivariate linear regression,considering multiple factors such as age,gender,duration,etiology,BMI,level of consciousness.Result:Considering confounding factors(age,gender,duration of illness,etiology,BMI,and level of consciousness),there were correlations between CRS-R(hearing)and MMN(F4 latency);CRS-R(vision)and MMN(Cz amplitude);MMN(Fz amplitude),MMN(F;amplitude),CRS-R(movement)and MMN(Cz amplitude)and MMN(F4 amplitude);CRS-R(arousal)and MMN(F4 latency);CRS-R(total score)and MMN(Cz amplitude).The correlation coefficients was significant:Cz(amplitude)with CRS-R(motion)at 0.759,F4(amplitude)with CRS-R(motion)at 0.689,Fz(amplitude)with CRS-R(vision)at 0.685.There were also correlations between CRS-R(auditory)and P300(F;amplitude),CRS-R(visual)and P300(Cz amplitude),CRS-R(mouth movement)and P300(F4 latency,Fz latency).Conclusion:There are significant correlations between the various scoring items of CRS-R scale and the amplitude and latency of MMN and P300 electrode points.These findings provide objective and direct electrophysiological evidence to support the clinical behavioral evaluation of chronic consciousness disorder.

关 键 词：事件相关电位 失匹配负波 慢性意识障碍 昏迷恢复量表 

分 类 号：R493[医药卫生—康复医学] R742[医药卫生—临床医学]