非痴呆型血管性认知障碍患者认知康复前后P300的相关研究

发布时间：2018-05-16 19:49

本文选题：事件相关电位 + P300　；参考：《青岛大学》2012年硕士论文

【摘要】：目的研究非痴呆型血管性认知障碍患者(vascular cognitive impairment-no dementia, VCIND)认知康复前后神经心理学量表及听觉事件相关电位(auditory event-related potential, ERP-P300)的变化情况,探讨VCIND患者的早期认知功能特点及P300在早期诊断血管性认知障碍(vascular cognitive impairment, VCI)的应用价值。方法选取在我院康复科病房及门诊就诊的VCIND患者57例和同期住院的认知功能正常者30例,将57例VCIND患者随机分成治疗组和对照组。两组患者均进行常规康复治疗,且治疗组针对患者不同的认知障碍设计训练题目,常规康复和认知训练均每天训练1次,每次60min,每周5次。分别对患者进行康复训练前后P300检测和认知量表各项评分,并与年龄、教育等因素进行分析评价。结果①VCIND组与正常组的性别、年龄、受教育年限等一般资料差异无统计学意义(P0.05)；治疗组与对照组在分组时的各项认知量表评分及P300各项指标差异无统计学意义(P0.05)。②治疗前VCIND组较正常组P300潜伏期延长,波幅降低(P0.05),以潜伏期延长更显著(P0.01); Barthel指数评分(BI)、简明精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)较正常组偏低(P0.05)；但在命名、语言方面与正常组差异无统计学意义(P0.05)。③年龄与P300潜伏期呈正相关(P0.05)；受教育年限与P300潜伏期呈负相关(P0.05); MMSE、 MoCA评分与P300潜伏期呈负相关(P0.05)。④认知康复后VCIND患者P300潜伏期缩短,波幅增高(P0.05),认知量表各项评分提高(P0.05)；并且治疗组各项指标变化较对照组更显著,差异有统计学意义(P0.05)。结论①VCIND患者存在广泛的认知领域损害,特别是视空间与执行功能、延迟回忆方面受损严重,所以应在认知损害早期进行全面的神经心理学评估。②P300作为一种电生理指标,能比较客观地反映VCIND患者的早期认知功能障碍。③早期认知康复训练能更好地改善VCI患者的认知功能。
[Abstract]:Objective to study the changes of neuropsychological scale and auditory event-related potential (ERP-P300) in vascular cognitive impairment-no dementias before and after cognitive rehabilitation in patients with non-dementia vascular cognitive impairment. To investigate the characteristics of early cognitive function in patients with VCIND and the value of P300 in the early diagnosis of vascular cognitive impairment, VCI). Methods 57 patients with VCIND and 30 patients with normal cognitive function were randomly divided into treatment group and control group. The patients in both groups were treated with routine rehabilitation, and the patients in the treatment group designed training topics for different cognitive disorders. The routine rehabilitation and cognitive training were conducted once a day for 60 mins, 5 times a week. Before and after rehabilitation training, the P300 test and the scores of cognitive scale were analyzed and evaluated with the factors of age, education and so on. Results Sex and age of 1VCIND group and normal group, There was no significant difference in general data such as years of education between treatment group and control group (P 0.05), and there was no significant difference in scores of cognitive scales and P300 indexes between treatment group and control group. The latent period of P300 in VCIND group was longer than that in normal group before treatment. The amplitude of P0.05 was decreased, and the latency was prolonged significantly (P0.01). The Barthel index score (BI), brief mental state examination (MMSE), and Montreal Cognitive Assessment scale (MOCA) were lower than those in the normal group (P 0.05), but in the name, there was no significant difference between the two groups. There was no significant difference between language and normal group. There was a positive correlation between P0.05.3 age and P300 latency, a negative correlation between P300 latency and education years, and a negative correlation between P300 latency and MMSE, MoCA score and P300 latency. The P300 latency was shortened in VCIND patients after cognitive rehabilitation, MMSE, MoCA score and P300 latency were negatively correlated with P300 latency. The amplitude increased (P 0.05), the scores of cognitive scale increased (P 0.05), and the changes of each index in the treatment group were more significant than those in the control group (P 0.05). Conclusion patients with 1VCIND have extensive cognitive impairment, especially visual space and executive function, and delayed recall. Therefore, a comprehensive neuropsychological evaluation of .2P300 should be carried out as an electrophysiological index in the early stage of cognitive impairment. Early cognitive rehabilitation training can better improve the cognitive function of VCI patients.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1

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