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目的通过分析一氧化碳中毒后迟发脑病患者认知功能损害与事件相关电位(P3a)各成分潜伏期及波幅的关系,探讨P3的出现率及对预后的判断。方法对20例一氧化碳中毒后迟发脑病患者测试前应用简易精神状态检查量表(MMSE)及Blessed行为量表评分;采用阴性刺激,被动方式,听觉“oddball”刺激序列诱发P3a成分。结果P3出现率为55%,N2出现率70%;引出P3者与对照组相比,P3、N2潜伏期显著延长,未引出P3者与对照组相比,N1、P2潜伏期延长;急性一氧化碳中毒时昏迷时间长短与N2潜伏期之间有线性关系;引出P3和未引出P3患者临床Blessed量表评分之间有显著性差异;随访病例中,多数引出P3者,临床症状好转。结论P300可能成为测试一氧化碳中毒后迟发脑病患者认知损害严重性和判断预后的一项客观标准。
Objective To investigate the relationship between cognitive impairment and the latency and amplitude of each component of event-related potential (P3a) in patients with delayed encephalopathy after carbon monoxide poisoning, and to explore the incidence of P3 and its prognosis. Methods Twenty patients with post-carbon monoxide poisoning delayed encephalopathy were assessed with MMSE and Blessed behavioral score before the test. The P3a components were induced by negative, passive and auditory “oddball” stimulation. Results The incidence of P3 was 55% and that of N2 was 70%. Compared with the control group, the P3 and N2 expansions significantly prolonged. The latency of N1 and P2 was prolonged when P3 was not induced compared with the control group. When acute carbon monoxide poisoning There was a linear relationship between coma duration and N2 latency; there was a significant difference between the clinical P3-lead and P3-negative Blessed scores; in the follow-up cases, most of the patients lead to P3, the clinical symptoms improved. Conclusion P300 may become an objective criterion for testing the severity of cognitive impairment and prognosis in patients with delayed encephalopathy after carbon monoxide poisoning.