P300和总脑小血管病评分对脑小血管病患者认知 障碍评估的临床价值
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Research on the clinical value of P300 and total cerebral small vessel disease (CSVD) score in cognitive impairment assessment in patients with CSVD
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    摘要:

    目的 本研究旨在评估 P300、总脑小血管病(CSVD)评分对 CSVD 患者认知障碍程度的 检测作用,并探讨认知功能筛查量表与之匹配程度。方法 纳入 2018 年 10 月至 2020 年 6 月就诊于 连云港东方医院神经内科并诊断CSVD的患者72例,同时纳入同期评价的年龄、性别与之匹配的34名 健康体检者设为对照组。所有纳入者均在一周内检查简易智力状态检查量表(MMSE)和蒙特利尔 认知评估量表(MoCA)和 P300、总 CSVD 评分。CSVD 患者根据认知功能筛查量表(MMSE、MoCA)分 为认知障碍组和非认知障碍组,分析 3 组间 MMSE、MoCA 评分与 P300 潜伏期、P300 波幅、总 CSVD 评分的关系。结果 认知障碍组和非认知障碍组在中央点(Cz)记录的P300 潜伏期均长于对照组 (P< 0.001),认知障碍组P300 潜伏期长于非认知障碍组[(397.471±35.911)ms比(342.584±14.502)ms, P< 0.001]。认知障碍组和非认知障碍组的总 CSVD 评分高于对照组(P< 0.001),认知障碍组总 CSVD 评 分 高 于 非 认 知 障 碍 组(P< 0.001)。 相 关 分 析 显 示 MMSE、MoCA 评 分 与 P300 潜 伏 期(r=-0.768, P< 0.001;r=-0.824,P< 0.001)、总 CSVD 评 分 之 间(r=-0.816,P< 0.001;r=-0.896,P< 0.001)存 在 强负相关关系。当 P300-Cz 潜伏期为 348.4 ms 时,CSVD 患者诊断认知障碍的敏感度为 94.3%,特异 度为 83.1%。当总 CSVD 评分为 2 分时,CSVD 患者诊断认知障碍的敏感度为 82.9%,特异度 97.2%。 结论 P300 潜伏期、总 CSVD 评分可能是 CSVD 患者认知功能障碍的早期预测指标,且较 MMSE、MoCA 量表可能更客观地反映认知功能

    Abstract:

    Objective To evaluate the clinical value of P300 and total cerebral small vessel disease (CSVD) score in detecting the degree of cognitive impairment in patients with CSVD, and to explore their matching degree with cognitive function screening scale. Methods A total of 72 patients diagnosed with CSVD in the Department of Neurology of Lianyungang Oriental Hospital from October 2018 to June 2020 were included, and 34 normal physical examinees matched by age and gender were included as the control group. Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), P300 and total CSVD scores were examined within one week for all the subjects included. According to the cognitive function screening scale (MMSE, MoCA), CSVD patients were divided into cognitive impairment group and non-cognitive impairment group. The relationship between MMSE and MoCA scores, and P300 latency, P300 amplitude, and total CSVD score among the three groups was analyzed. Results The latency of P300 recorded at the central point (CZ) in cognitive impairment group and non-cognitive impairment group was longer than that in control group (P<0.001).The latency of P300 recorded in cognitive impairment group was longer than that in non-cognitive impairment group[(397.471±35.911) ms vs. (342.584±14.502) ms,P < 0.001]. The total CSVD score of cognitive impairment group and non-cognitive impairment group was higher than that of control group (P< 0.001), and the total CSVD score of cognitive impairment group was higher than that of non-cognitive impairment group (P< 0.001). Correlation analysis results showed that MMSE and MoCA scores have strong negative correlations with P300 latency (r=-0.768,P< 0.001;r=-0.824,P< 0.001) and total CSVD score (r=-0.816,P< 0.001; r=-0.896, P < 0.001). When the CZ of P300 latency was 348.4 ms, the sensitivity and specificity of CSVD were 94.3% and 83.1%, respectively. When the total CSVD score was 2, the sensitivity and specificity of CSVD were 82.9% and 97.2%, respectively. Conclusions P300 latency and total CSVD score may be the indicator of cognitive impairment in patients with CSVD for the early stage, and can reflect cognitive function more objectively than MMSE and MoCA.

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韩学聃 任孝林 孔令胜 赵平 耿德勤. P300和总脑小血管病评分对脑小血管病患者认知 障碍评估的临床价值[J].神经疾病与精神卫生,2021,21(9):
DOI :10.3969/j. issn.1009-6574.2021.09.010.

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  • 在线发布日期: 2021-09-28