本文選題：事件相關(guān)電位 + P300��； 參考：《青島大學(xué)》2012年碩士論文

【摘要】：目的研究非癡呆型血管性認(rèn)知障礙患者(vascular cognitive impairment-no dementia, VCIND)認(rèn)知康復(fù)前后神經(jīng)心理學(xué)量表及聽覺事件相關(guān)電位(auditory event-related potential, ERP-P300)的變化情況,探討VCIND患者的早期認(rèn)知功能特點及P300在早期診斷血管性認(rèn)知障礙(vascular cognitive impairment, VCI)的應(yīng)用價值。 方法選取在我院康復(fù)科病房及門診就診的VCIND患者57例和同期住院的認(rèn)知功能正常者30例,將57例VCIND患者隨機(jī)分成治療組和對照組。兩組患者均進(jìn)行常規(guī)康復(fù)治療,且治療組針對患者不同的認(rèn)知障礙設(shè)計訓(xùn)練題目,常規(guī)康復(fù)和認(rèn)知訓(xùn)練均每天訓(xùn)練1次,每次60min,每周5次。分別對患者進(jìn)行康復(fù)訓(xùn)練前后P300檢測和認(rèn)知量表各項評分,并與年齡、教育等因素進(jìn)行分析評價。 結(jié)果①VCIND組與正常組的性別、年齡、受教育年限等一般資料差異無統(tǒng)計學(xué)意義(P0.05)；治療組與對照組在分組時的各項認(rèn)知量表評分及P300各項指標(biāo)差異無統(tǒng)計學(xué)意義(P0.05)。②治療前VCIND組較正常組P300潛伏期延長,波幅降低(P0.05),以潛伏期延長更顯著(P0.01); Barthel指數(shù)評分(BI)、簡明精神狀態(tài)檢查(MMSE)、蒙特利爾認(rèn)知評估量表(MoCA)較正常組偏低(P0.05)；但在命名、語言方面與正常組差異無統(tǒng)計學(xué)意義(P0.05)。③年齡與P300潛伏期呈正相關(guān)(P0.05)；受教育年限與P300潛伏期呈負(fù)相關(guān)(P0.05); MMSE、 MoCA評分與P300潛伏期呈負(fù)相關(guān)(P0.05)。④認(rèn)知康復(fù)后VCIND患者P300潛伏期縮短,波幅增高(P0.05),認(rèn)知量表各項評分提高(P0.05)；并且治療組各項指標(biāo)變化較對照組更顯著,差異有統(tǒng)計學(xué)意義(P0.05)。 結(jié)論①VCIND患者存在廣泛的認(rèn)知領(lǐng)域損害,特別是視空間與執(zhí)行功能、延遲回憶方面受損嚴(yán)重,所以應(yīng)在認(rèn)知損害早期進(jìn)行全面的神經(jīng)心理學(xué)評估。②P300作為一種電生理指標(biāo),能比較客觀地反映VCIND患者的早期認(rèn)知功能障礙。③早期認(rèn)知康復(fù)訓(xùn)練能更好地改善VCI患者的認(rèn)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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749.1

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