發(fā)布時(shí)間：2018-10-29 09:26

【摘要】：目的:探討胼胝體膝部梗塞患者聽覺事件相關(guān)電位P300(auditory event-related potential,P300)的特征,以P300為參考診斷胼胝體膝部梗塞的敏感性、特異性及診斷的受試者工作特征曲線(Receiver Operating Characteristic,ROC)下面積(Area under the ROC curve,AUC),進(jìn)一步了解胼胝體膝部梗塞患者聽覺事件相關(guān)電位P300的特點(diǎn),為臨床應(yīng)用其判斷胼胝體膝部梗死提供神經(jīng)電生理診斷依據(jù)。方法:選取2012年2月至2016年10月天津醫(yī)科大學(xué)總醫(yī)院神經(jīng)內(nèi)科門診和住院患者進(jìn)行分析。篩選其中腦CT和/或腦MRI確診為胼胝體膝部梗塞患者24例(病例組),與同期健康正常人群26例(對照組)為對照,進(jìn)行對比研究。應(yīng)用Nicolet Spirit腦電生理儀對胼胝體膝部梗塞患者及健康對照組進(jìn)行聽覺事件相關(guān)電位P300(auditory event-related potential,P300)檢測。比較胼胝體膝部梗塞患者及健康對照組聽覺事件相關(guān)電位P300的特征包括潛伏期、波幅等有無差別。根據(jù)貝葉斯定理,以聽覺事件相關(guān)電位P300潛伏期和波幅為參考指標(biāo),計(jì)算P300診斷胼胝體膝部梗塞的敏感性、特異性、陽性預(yù)測值、陰性預(yù)測值、診斷優(yōu)勢比及受試者工作特征曲線(ROC)下面積(AUC)。結(jié)果:1.病例組和對照組P300潛伏期分別為339.9±35.3ms和296.9±9.6ms,病例組顯著長于對照組(t=4.85,P0.05)。2.病例組和對照組波幅分別為6.1±0.9μV和8.4±0.7μV,病例組顯著低于對照組且差別有統(tǒng)計(jì)學(xué)意義(t=8.79,P0.05)。3.病例組簡易精神狀態(tài)檢查表(MMSE)評分平均為23.82±2.48,病例組患者M(jìn)MSE評分與P300波幅存在明顯的相關(guān)性(rspreason=0.63,P0.05),但mmse與潛伏期無明顯相關(guān)性(rspreason=-0.07,P=0.78)。4.以潛伏期為指標(biāo),診斷胼胝體膝部梗塞的敏感性為100%,特異性為83.3%,ROC曲線下面積為0.88。5.以波幅為參考指標(biāo)診斷診斷胼胝體膝部梗塞的敏感性為100%,特異性為95.8%,ROC曲線下面積為0.98。結(jié)論:1.胼胝體膝部梗塞患者組與對照組比較聽覺事件相關(guān)電位P300潛伏期存在差異,胼胝體膝部梗塞患者P300潛伏期明顯延長。2.胼胝體膝部梗塞患者組與對照組比較聽覺事件相關(guān)電位P300波幅存在差異,胼胝體膝部梗塞患者P300波幅顯著低于健康人群組。3.胼胝體膝部梗塞患者簡易精神狀態(tài)檢查表(MMSE)評分與聽覺事件相關(guān)電位P300波幅存在正相關(guān)性,即隨著波幅的增高,MMSE評分升高。4.以聽覺事件相關(guān)電位P300潛伏期為指標(biāo),診斷胼胝體膝部梗塞的敏感性較高,特異性尚可。5.以聽覺事件相關(guān)電位P300波幅為指標(biāo),診斷胼胝體膝部梗塞的敏感性和特異性均較高。
[Abstract]:Objective: to investigate the characteristics of auditory event-related potential (auditory event-related potential,P300) in patients with genu infarction of corpus callosum, and to evaluate the sensitivity, specificity and diagnostic operating characteristic curve (Receiver Operating Characteristic,) of genu infarction of corpus callosum using P300 as reference. To further understand the characteristics of auditory event-related potential (P300) in patients with genu infarction of corpus callosum, and to provide a basis for the clinical diagnosis of genu infarction of corpus callosum. Methods: the outpatients and inpatients of Department of Neurology, General Hospital of Tianjin Medical University from February 2012 to October 2016 were analyzed. Twenty-four patients with genu infarction of corpus callosum were diagnosed by brain CT and / or brain MRI, and 26 healthy subjects (control group) were selected as control group. The auditory event-related potential (auditory event-related potential,P300) was measured by Nicolet Spirit electrophysiological instrument in patients with genu infarction of corpus callosum and healthy control group. To compare the characteristics of auditory event-related potentials (P300) in patients with genu infarction of corpus callosum and healthy controls, including latency and amplitude. According to Bayesian theorem, the sensitivity, specificity, positive predictive value and negative predictive value of P300 in the diagnosis of genu infarction of corpus callosum were calculated by using P300 latency and amplitude of auditory event-related potential as reference indexes. Diagnostic odds ratio and area (AUC). Under operating characteristic Curve (ROC) The result is 1: 1. The latency of P300 in case group and control group was 339.9 鹵35.3ms and 296.9 鹵9.6 msrespectively, which was significantly longer than that in control group (t = 4.85, P0.05). The amplitudes of the case group and the control group were 6.1 鹵0.9 渭 V and 8.4 鹵0.7 渭 V, respectively, which were significantly lower than those of the control group (t = 8.79, P 0.05). The average (MMSE) score of mini-mental state examination in the case group was 23.82 鹵2.48. There was a significant correlation between MMSE score and P300 amplitude (rspreason=0.63,P0.05), but there was no significant correlation between mmse and latency (rspreason=-0.07,). P0. 78) 4. The sensitivity was 100 and the specificity was 83.3%. The area under the ROC curve was 0.88.5% for the diagnosis of genu infarction of corpus callosum. The sensitivity and specificity of wave amplitude in diagnosing genu infarction of corpus callosum were 100 and 0.98 respectively. Conclusion: 1. Compared with the control group, the latency of P300 was significantly prolonged in the patients with genu infarction of corpus callosum, and the latency of P300 was significantly prolonged in the patients with genu infarction of corpus callosum. 2. The amplitude of P300 in the patients with genu infarction of corpus callosum was significantly lower than that in the control group, and the amplitude of P300 in the patients with genu infarction of corpus callosum was significantly lower than that in the healthy subjects. There was a positive correlation between the (MMSE) score and the P300 amplitude of auditory event-related potential in the patients with genu infarction of corpus callosum, that is, the MMSE score increased with the increase of the amplitude. 4. The latency of auditory event-related potential (P300) was used as an index to diagnose the genu infarction of corpus callosum with a high sensitivity and a specificity of 0.5%. The sensitivity and specificity of P300 amplitude of auditory event-related potential in the diagnosis of genu infarction of corpus callosum were high.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.33

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 楊璇;周少旦;臧大維;;表現(xiàn)為異己手綜合征的胼胝體梗死一例[J];中華老年心腦血管病雜志;2015年12期

2 麗扎·滿蘇爾;巴哈古麗·阿爾斯朗;劉明超;庫木斯·巴雅合買提;;應(yīng)用P300評定中國老年期抑郁癥患者認(rèn)知功能的Meta分析[J];實(shí)用老年醫(yī)學(xué);2015年09期

3 關(guān)楠思;劉技輝;張馨元;王莞;譚嘉寧;彭博;;事件相關(guān)電位的研究進(jìn)展及其法醫(yī)學(xué)應(yīng)用價(jià)值[J];法醫(yī)學(xué)雜志;2015年02期

4 南彩;王高華;劉忠純;王惠玲;王曉萍;肖玲;;事件相關(guān)電位P300在抑郁癥中的研究進(jìn)展[J];國際精神病學(xué)雜志;2015年02期

5 杜好瑞;穆俊林;李六一;張寧;寇振芬;王世貴;張紅星;;精神分裂癥患者注意狀態(tài)對事件相關(guān)電位P300的影響[J];中國現(xiàn)代醫(yī)學(xué)雜志;2015年05期

6 梁靜;曾波濤;孟祥軍;;首發(fā)抑郁癥患者認(rèn)知功能與事件相關(guān)電位P300研究[J];中國健康心理學(xué)雜志;2015年02期

7 朱敏;張陽;魯曉波;翟歆明;;難治性和一般性抑郁癥患者記憶功能及事件相關(guān)電位P300的對比研究[J];山西醫(yī)科大學(xué)學(xué)報(bào);2014年12期

8 邵祥忠;秦延昆;黃曉勇;謝海洋;;胼胝體梗死的臨床特點(diǎn)及影像學(xué)分析[J];中國實(shí)用神經(jīng)疾病雜志;2014年23期

9 韓騏;;胼胝體梗死28例臨床分析[J];臨床合理用藥雜志;2014年34期

10 鐘智勇;陳霞;呂佑輝;廖曉玲;王\，

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