【摘要】 背景:听觉诱发电位P300是评价个体认知功能客观的电生理指标。应用听觉诱发电位P300探讨老年期精神病性抑郁患者认知功能损害的特征具有可靠性。目的:探讨老年期精神病性抑郁患者听觉诱发电位P300的特征。设计:以病例为观察对象的配对设计探索性观察。对象:于2002-01/2003-10选择河南省精神病医院抑郁症患者60例为观察对象。具有精神病症状患者21例为实验组1,无精神病症状患者39例为实验组2。对照组选择与实验组在年龄、性别上相匹配且无精神疾病阳性家族史的健康者60例。对照组样本来自河南省精神病医院退休人员及患者家属。与实验组1相匹配的21人为对照组1;与实验组2相匹配的39人为对照组2。方法:应用配对设计,对60例老年期抑郁症患者采用诱发电位系统完成听觉诱发电位P300检测。应用丹麦ECI公司针状电极。电极位置参照国际脑电图学会10/20标准,记录电极置于中央中线Cz点,参考电极置于右耳M2点,前额FPz点接地,电极间阻抗小于5K,分析时间为1000ms。被检者接受双耳的短音刺激,刺激频率为1次/s,刺激持续时间10ms,灵敏度为5μV,带通低频滤波0.1Hz,高频滤波50Hz,叠加200次。采用两套触发和刺激系统、两个完全独立的时间窗口来进行听觉诱发电位P300检测。非靶刺激(NT)强度为85dB,频率为1000Hz,占80%。靶刺激(T)频率为2000Hz,强度为95dB,随机出现,串插在非靶刺激中,占20%。两者次序关系的范例如下:NTNTNTTNTNTNTNTTTNTNTNTNTNTTNTNTNT。受试者对靶刺激作按键反应,每例重复两次,取平均值。主要观察指标:①靶刺激N1,P2,N2,P3潜伏期及波幅。②反应时间。结果:实验组1及实验组2听觉诱发电位P300,P2,N2,P3潜伏期、反应时间分别比对照组明显延长,P2,N2,P3波幅分别比对照组明显降低(P<0.05及P<0.01)。实验组1P3潜伏期及反应时间比实验组2明显延长(P<0.01)。结论:听觉诱发电位P300对老年期抑郁症认知功能损害评定有一定意义。具有精神病性症状与无精神病性症状的老年期抑郁症P300改变的特征不十分一致,提示精神病性症状加重老年期抑郁症患者认知功能的损害。更多还原

【Abstract】 BACKGROUND:Auditory evoked potential P300 is the objective index of evaluating individual’s cognitive function, with which to investigate the character of cognitive impairment of patients with senile psychotic depression is reliable. OBJECTIVE: To investigate the character of auditory evoked potential P300 of the patients with senile psychotic depression.DESIGN: Paired design, groping observation based on casePARTICIPANTS: The research was carried out in the Mental Health Hospital of Henan Province from January 2002 to October 2003. 60 patients with depression were recruited and subdivided into two groups: experimental group 1, 21 patients with psychotic syndromes, experimental group 2, 39 patients without psychotic syndromes. Sixty healthy persons, had no positive family history of psychotic syndromes, marched for sex and age to experimental group, retired from work, came from patients’s relatives of Henan Provincial Mental Health Hospital, were selected as normal control group, and subdivided into two groups: normal control group1, 21 persons, normal control group 2, 39 persons.METHODS: Paired design was applied and auditory evoked potential P300 was detected with auditory evoked potential system. The needle electrodes made in ECI Company Denmark were used. According to International Electroencephalology Association 10-20 system criteria, record electrode was placed in Cz; conference electrode was placed in M2; ground wire was lined in FPz. The impedance between two electrodes was less than 5K . 800 milliseconds were analyzed. Subjects were received short tone stimulus through two ears. Frequency of stimulation was one time per second; persistence time was 10 milliseconds ; susceptibility was 5μV; band-pass low frequency transduction smoothing was 0.1Hz; high-frequency smoothing was 50 Hz; stratum super stratum 200 times. Two evoked and stimulated systems and two independent time windows were applied to measure potential P300. Nontarget(NT)( frequency 1000 Hz; intensity 85 dB ) occupied 80 percent. Target (T) (frequency 2000 Hz; intensity 95 dB) occupied 20 percent and appeared randomly among nontarget stimulations. The sequence paradigm between nontarget and target was as following: NT NT NT T NT NT NT NT T T NT NT NT NT NT T NT NT NT. All subjects knobbed response to target stimulations two times and averaged value were received as outcome.MAIN OUTCOME MEASURES: ①Auditory evoked potential P300 component N1, P2, N2, P3 latency and amplitude ② reactive time changes.RESULTS: Latency and reactive time of P300 and P2, N2 and P3 of auditory evoked potential in the experimental group 1 and experimental group 2 were significantly prolonged than that in the control group respectively, the amplitude of P2, N2 and P3 were obviously decreased than that in the control group (P < 0.05 and P < 0.01). Latency and reactive time in the experimental group 1 were significantly prolonged than that in the control group (P < 0.01).CONCLUSION: It is worthy of utilizing P300 to value the cognitive impairment in the senile depression. The character of auditory evoked potential P300 is different between the senile psychotic depression and the senile non-psychotic depression, which might deduce that psychotic syndrome enhances cognitive impairment.更多还原