摘要
目的:探讨慢性意识障碍患者昏迷恢复量表(CRS-R)与事件相关电位MMN、P300的相关性,从而确立CRS-R量表联合事件相关电位评估慢性意识障碍患者意识水平的临床价值。方法:按照入选标准纳入意识障碍患者61例,所有纳入患者在同一时间段(即72h内)完成CRS-R评定及事件相关电位(MMN和P300)检查。先对所收集的数据行正态性检验,符合正态分布的数据采用Pearson相关性分析,不符合正态分布的数据采用Spearman相关性分析,然后将具有相关性的两组数据在考虑年龄、性别、病程、病因、BMI、意识水平等多因素响的情况下进行线性回归多因素分析。结果:在考虑年龄、性别、病程、病因、BMI、意识水平等混杂因素的情况下,CRS-R(听觉)与MMN(F4潜伏期)、CRSR(视觉)与MMN(CZ波幅)、MMN(FZ波幅)、MMN(F3波幅),CRS-R(运动)与MMN(CZ波幅)和MMN(F4波幅),CRS-R(唤醒度)与MMN(F4潜伏期),CRS-R(总分)与MMN(CZ波幅)存在相关性,其中CZ(波幅)与CRS-R(运动)相关系数为0.759、F4(波幅)与CRS-R(运动)相关系数为0.689、FZ(波幅)与CRSR(视觉)相关系数为0.685,为显著相关。而CRS-R(听觉)与P300(F3波幅)、CRS-R(视觉)与P300(CZ波幅)、CRS-R(口部运动)与P300(F4潜伏期、FZ潜伏期)均存在相关性。结论:CRS-R量表各评分项目与MMN、P300电极点的波幅、潜伏期存在相关性,为慢性意识障碍的临床行为学评估提供电生理检测的客观、直接证据。
Objective:To explore the correlation between coma recovery scale(CRS-R)and event-related potential MMN and P300 in patients with prolonged disorders of consciousness,thereby establishing the clinical value of CRS-R scale combined with event-related potential in assessing the level of consciousness in these patients.Method:Sixty-one patients with disturbance of consciousness were enrolled according to the inclusion criteria,and all patients completed the CRS-R assessment and event-related potential(MMN and P300)within the same time period(72 hours).The data olected were first subiccted to a normality test,and the data with normal distribution were examined by pearson correlation analysis,while the data that did not fit a normnal dis-tribution were analyzed using spearman correlation.Then,the two sets of data that showed corrclation were fur-ther analyzed using multivariate linear regression,considering multiple factors such as age,gender,duration,etiology,BMI,level of consciousness.Result:Considering confounding factors(age,gender,duration of illness,etiology,BMI,and level of consciousness),there were correlations between CRS-R(hearing)and MMN(F4 latency);CRS-R(vision)and MMN(Cz amplitude);MMN(Fz amplitude),MMN(F;amplitude),CRS-R(movement)and MMN(Cz amplitude)and MMN(F4 amplitude);CRS-R(arousal)and MMN(F4 latency);CRS-R(total score)and MMN(Cz amplitude).The correlation coefficients was significant:Cz(amplitude)with CRS-R(motion)at 0.759,F4(amplitude)with CRS-R(motion)at 0.689,Fz(amplitude)with CRS-R(vision)at 0.685.There were also correlations between CRS-R(auditory)and P300(F;amplitude),CRS-R(visual)and P300(Cz amplitude),CRS-R(mouth movement)and P300(F4 latency,Fz latency).Conclusion:There are significant correlations between the various scoring items of CRS-R scale and the amplitude and latency of MMN and P300 electrode points.These findings provide objective and direct electrophysiological evidence to support the clinical behavioral evaluation of chronic consciousness disorder.
作者
董艺
谭浩
陶希
宋涛
DONG Yi;TAN Hao;TAO Xi(The First Affiliated Hospital of Hunan Normal University,Hunan Provincial People's Hospital,Changsha,410016)
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2024年第5期663-668,共6页
Chinese Journal of Rehabilitation Medicine
基金
长沙市科技局科研项目(kq2004122)。
关键词
事件相关电位
失匹配负波
慢性意识障碍
昏迷恢复量表
event-related potentials
mismatch negativity
chronic disturbance of consicousness
the coma recovery scale-revised
