脑电图对急性脑卒中后认知障碍的评价  

Evaluation of cognitive impairment after acute stroke by electroencephalogram

作　　者：齐秀琴 宋晶晶 Qi Xiuqin;Song Jingjing(Special Inspection Division,Pingdingshan First People′s Hospital,Henan467021,China)

机构地区：[1]河南省平顶山市第一人民医院特检科,467021

出　　处：《山西医药杂志》2024年第22期1697-1701,共5页Shanxi Medical Journal

摘　　要：目的探讨脑电图预测急性脑卒中后认知障碍的价值。方法选取2020年2月至2023年1月本院收治的120例急性脑卒中患者为对象,根据发病3个月后认知功能障碍发生情况分为认知障碍组(31例)和认知正常组(89例)。患者均接受脑电图检查,分析脑电图参数与急性脑卒中患者认知功能的关系及其预测认知障碍的价值。结果认知障碍组α波功率低于认知正常组,而θ波功率、(δ波+θ波)/(α波+β波)(DTABP)、δ波/α波比值(DAR)高于认知正常组(P<0.05)。2组β波、δ波功率比较差异无统计学意义(P>0.05)。认知障碍组执行功能、方向感知、数学计算、语言能力、记忆力、视空间功能、注意力、抽象思维能力评分均低于认知正常组(P<0.05)。Pearson相关性分析显示,α波功率与MoCA-B评分呈正相关(P<0.05);θ波功率、DTABR、DAR与蒙特利尔认知基础量表(MoCA-B)评分呈负相关(P<0.05)。Logistic多因素回归分析结果显示,θ波功率(OR=2.651)、δ波/α波比值(DAR)(OR=16.497)为认知障碍的独立预测因素(P<0.05)。θ波预测急性脑卒中后认知障碍的AUC(95%CI)、灵敏度、特异度分别为0.758(0.672,0.832)、71.0%、92.1%;DAR预测急性脑卒中后认知障碍的AUC(95%CI)、灵敏度、特异度分别为0.863(0.788,0.919)、64.5%、93.3%;联合检测预测急性脑卒中后认知障碍的AUC(95%CI)、灵敏度、特异度分别为0.982(0.939,0.998)、100%、88.8%。联合检测预测急性脑卒中后认知障碍的AUC高于θ波、DAR(P<0.05)。结论急性脑卒中患者脑电图参数与认知功能存在联系,可用于急性脑卒中后认知障碍的早期预测。Objective To investigate the value of electroencephalogram(EEG)in predicting cognitive impairment after acute stroke.Methods One hundred and twenty patients with acute stroke admitted to our hospital from February 2020 to January 2023 were selected as subjects and divided into cognitive impairment group(n=31)and normal group(n=89)according to the occurrence of cognitive dysfunction 3 months after the onset of stroke.All patients underwent EEG examination to analyze the relationshipbetween EEG parameters,cognitive function in patients with acute stroke and its value in predicting cognitive impairment.Results The α wave power of the cognitive impairment group was lower than that of the normal group,while θ wave power,(δ wave/θ wave)(α wave/β wave)DTABP,and δ wave/a wave(DAR)were higher than that of the normal group(P<0.05).There was no significant difference inβwave and δ wave power between the two groups(P>0.05).The scores of executive functions,direction perception,mathematical calculation,language ability,memory,visuospatial function,attention,and abstract thinking ability in the cognitive impairment group were lower than those in the normal group(P<0.05).Pearson correlation analysis showed thatαwave power was positively correlated with the MoCA-B score(P<0.05).θwave power,DTABR,DAR,and MoCA-B score were negatively correlated(P<0.05).Logistic multivariate regression analysis showed thatθpower(OR=2.651)and DAR(OR=16.497)were independent predictors of cognitive impairment after acute stroke(P<0.05).The area under the curve(AUC)(95%CI),sensitivity,and specificity of θ wave in predicting cognitive impairment after acute stroke were 0.758(0.672,0.832),71.0%,and 92.1%,respectively.The AUC(95%CI),sensitivity,and specificity of DAR for predicting cognitive impairment after acute stroke were 0.863(0.788,0.919),64.5%and 93.3%,respectively.The AUC(95%CI),sensitivity,and specificity of the combined test for predicting cognitive impairment after acute stroke were 0.982(0.939,0.998),100%,and 88.8%,respectively.Th

关 键 词：脑电描记术 卒中 认知障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]