丙泊酚作用下反应性消失与意识消失之间听觉事件相关电位的差异  

Differences in auditory event‑related potentials associated with loss of responsiveness and loss of consciousness under propofol sedation

作　　者：王昕馨 杨宛凝 梁艺 菅敏钰[1] 马博 韩如泉()[1] Wang Xinxin;Yang Wanning;Liang Yi;Jian Minyu;Ma Bo;Han Ruquan(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,北京100070

出　　处：《国际麻醉学与复苏杂志》2024年第5期462-467,共6页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金(82271284);北京市自然科学基金/北京市教育委员会科技计划重点项目(23JG0059)。

摘　　要：目的通过听觉事件相关电位(AERP)探讨反应性消失(LOR)与意识消失(LOC)状态下意识活动相关的神经响应差异。方法采用基于Oddball范式的听觉实验探索健康受试者在丙泊酚镇静的LOR与LOC状态下包括失匹配负波(MMN)和P300成分在内的AERP平均波幅的差异。结果25例健康受试者数据分析结果显示:新异刺激(Nov)诱发的MMN(MMN‑Nov)平均波幅在LOR和LOC状态下差异有统计学意义[(−4.2±5.0)μV比(−0.6±6.4)μV,P<0.05],但偏差刺激(Dev)诱发的P300(P300‑Dev)以及Nov诱发的P300(P300‑Nov)平均波幅在LOR与LOC状态下差异无统计学意义[P300‑Dev:(1.5±3.0)μV比(1.9±4.3)μV,P>0.05;P300‑Nov:(2.3±4.6)μV比(2.1±5.3)μV,P>0.05]。结论MMN‑Nov平均波幅在丙泊酚诱导的LOR与LOC状态下存在差异,或为区分麻醉药物作用下LOR与LOC的潜在电生理学指标。Objective To investigate the differences in neural responses related to consciousness activity under loss of responsiveness(LOR)and loss of consciousness(LOC)states through auditory event‑related potential(AERP).Methods An auditory experiment based on the Oddball paradigm was used to explore the differences in the average wave amplitudes of AERP,including the mismatch negativity(MMN)and P300 components,in healthy subjects under the LOR and LOC states through propofol sedation.Results Twenty‑five healthy subjects were included for data analysis.The results showed that there was statistical difference in the average wave amplitudes of MMN induced by novelty(MMN‑Nov)between the LOR and LOC states[(−4.2±5.0)μV vs(−0.6±6.4)μV,P<0.05].However,no statistical difference was found in the average wave amplitudes of P300 induced by deviation(P300‑Dev)and P300 induced by novelty(P300‑Nov)between the LOR and LOC states[P300‑Dev:(1.5±3.0)μV vs(1.9±4.3)μV,P>0.05;P300‑Nov:(2.3±4.6)μV vs(2.1±5.3)μV,P>0.05].Conclusions The MMN‑Nov shows a difference between propofol‑induced LOR and LOC states,which may serve as an electrophysiological indicator for differentiating LOR and LOC under the effect of anesthetic sedation.

关 键 词：丙泊酚 反应性消失 意识消失 听觉事件相关电位 

分 类 号：R614[医药卫生—麻醉学]