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目的:探讨腔隙性脑梗死患者认知功能与脑事件相关电位的关系。方法:连续收集2014—2019年就诊于开滦总医院神经内科的腔隙性脑梗死患者464例作为观察对象（病例组），进行前瞻性队列研究。病例组依据简易智能精神状态（mini-mental state examination，MMSE）评分分为认知正常组352例和轻度认知障碍组112例。同时选取同期100名健康体检志愿者为对照组。对所有研究对象进行简易智能精神状态、宗氏焦虑、宗氏抑郁量表测评和脑事件相关电位P3a和P3b检测。正态分布的计量资料采用单因素方差分析，非正态分布的计量资料采用Kruskal-Wallis n H检验，计数资料采用n χ2检验，非条件Logistics（逐步法）进行多因素统计学分析。n 结果:对照组、认知正常组、轻度认知障碍组占比吸烟者分别为20.00%（20/100）、38.07%（134/352）、46.42%（52/112）；饮酒者分别为18.00%（18/100）、33.24%（117/352）、33.93%（38/112）；高血压分别为38.00%（38/100）、58.24%（205/352）、59.82%（67/112）；高同型半胱氨酸血症分别为19.00%（19/100）、34.00%（120/352）、68.75%（77/112），3组间比较差异均有统计学意义（n χ2值分别为15.66、7.91、11.86、54.57，n P<0.001、n P=0.019、n P=0.003、n P<0.001）。3组视觉P3b波群N2峰潜伏期CZ导联分别为（271.48±40.65）、（285.67±44.08）、（290.57±68.41）ms，PZ导联分别为（276.70±50.92）、（287.86±43.28）、（312.16±62.75）ms；P3b峰潜伏期FZ导联分别为（392.67±42.50）、（405.82±52.43）、（410.34±64.27）ms，CZ导联分别为（395.04±42.44）、（412.51±55.86）、（433.28±66.32）ms，PZ导联分别为（398.24±40.93）、（411.17±49.48）、（435.78±67.69）ms；N2波幅CZ导联分别为（-3.99±2.81）、（-3.60±3.00）、（-2.70±2.37）μV，PZ导联分别为（-3.18±2.69）、（-2.91±2.62）、（-1.87±2.89）μV；P3b波幅FZ导联分别为5.27（3.27，7.40）、4.21（2.31，6.49）、3.12（1.61，5.08）μV，CZ导联分别为4.81（2.78，6.71）、4.15（2.76，6.16）、3.51（1.75，5.15）μV，PZ导联分别为5.17（3.03，6.97）、4.40（2.89，6.12）、3.43（1.52，5.34）μV，3组间比较差异均有统计学意义（n F值分别为3.29、14.49、3.95、11.73、14.06、5.66、3.57，n H值分别为18.23、10.33、18.25，n P值分别为0.027、<0.001、0.025、<0.001、<0.001、0.004、0.042、<0.001、0.006、<0.001）。视觉P3a波群N2峰潜伏期FZ导联分别为265.00（256.00，286.00）、277.00（260.00，300.00）、282.00（270.00，304.00）ms，CZ导联分别为274.00（255.00，305.00）、285.00（262.00，329.00）、293.50（270.00，346.00）ms；P3a峰潜伏期FZ导联分别为（413.83±49.58）、（429.83±55.38）、（449.04±54.79）ms，CZ导联分别为（441.53±61.78）、（457.12±69.29）、（460.23±72.24）ms，PZ导联分别为（430.14±54.53）、（462.31±69.2）、（470.02±74.92）ms；N2波幅FZ导联分别为（-6.34±3.13）、（-5.72±2.96）、（-4.92±2.05）μV；P3a波幅FZ导联分别为4.00（2.28，5.55）、3.15（2.14，4.91）、2.80（2.19，4.19）μV，CZ导联分别为3.37（1.98，4.66）、2.73（1.70，3.97）、2.41（1.64，3.45）μV，3组间比较差异均有统计学意义（n H值分别为13.92、8.65、9.17、10.02，n F值分别为8.18、6.33、10.73、4.62，n P值分别为0.001、0.013、0.010、0.007、<0.001、0.002、<0.001、0.010）。Logistic回归分析结果为饮酒、视觉P3b峰潜伏期和波幅PZ导联、视觉P3a波群的N1波幅FZ导联是MMSE的影响因素（n OR值分别为0.04、1.01、0.76、1.51，95%CI分别为0.00~0.30、1.00~1.03、0.59~0.97、1.08~2.10，n P值分别为0.002、0.007、0.029、0.016）。n 结论:腔隙性脑梗死患者脑事件相关电位P3b和P3a波群的内源性心理认知电位N2、P3b、P3a峰潜伏期延长、波幅减低，同时这些认知电位随临床认知障碍的发生，其峰潜伏期进一步延长、波幅减低更加明显。饮酒、视觉P3b波群的P3b峰潜伏期和波幅PZ导联、视觉P3a波群的N1波幅FZ导联是简易智能精神状态的影响因素。“,”Objective:To investigate the relationship between cognitive function and brain event-related potential in patients with lacunar cerebral infarction.Methods:A total of 464 patients with lacunar cerebral infarction admitted to the Department of Neurology, Kailuan General Hospital from 2014 to 2019 were prospectively selected as observation subjects (case group). According to mini-mental state examination (MMSE) score, the patients in the case group were divided into 352 cases of lacunar cerebral infarction with normal cognition and 112 cases of mild cognitive impairment. At the same time, 100 healthy volunteers were selected as the control group. All subjects were assessed by simple intelligent mental state, Zung self-rating anxiety scale, Zung self-rating depression scale and brain event-related potential P3a and P3b. The measurement data of normal distribution adopts one-way ANOVA, the measurement data of non normal distribution adopts Kruskal Wallis n H test, and the counting data adopts n χ2. Multivariate statistical analysis was performed by unconditional Logistics (stepwise method).n Results:The proportions of smokers in control group, lacunar cerebral infarction cognitive normal group and lacunar cerebral infarction mild cognitive impairment group were 20.00% (20/100), 38.07% (134/352) and 46.42% (52/112), respectively. The proportions of drinkers were 18.00% (18/100), 33.24% (117/352), 33.93% (38/112), respectively. The proportions of hypertension were 38.00% (38/100), 58.24% (205/352), 59.82% (67/112), respectively. The proportions of hyperhomocysteinemia were 19.00% (19/100), 34.00% (120/352) and 68.75% (77/112), respectively, and the differences among the three groups were statistically significant (n χ2 values were 15.66, 7.91, 11.86 and 54.57, respectively; n P<0.001, 0.019, 0.003, <0.001). The peak latency CZ leads of visual P3b wave group N2 were (271.48±40.65), (285.67±44.08) and (290.57±68.41) ms, respectively. PZ leads were (276.70±50.92), (287.86±43.28) and (312.16±62.75) ms. P3b peak latency FZ leads were (392.67±42.50), (405.82±52.43) and (410.34±64.27) ms. CZ leads were (395.04±42.44), (412.51±55.86) and (433.28±66.32) ms. PZ leads were (398.24±40.93), (411.17±49.48) and (435.78±67.69) ms. N2 amplitude CZ leads were (-3.99±2.81), (-3.60±3.00) and (-2.70±2.37) μV, PZ leads were (-3.18±2.69), (-2.91±2.62) and (-1.87±2.89) μV, respectively. Leads P3b amplitude of FZ were 5.27 (3.27, 7.40), 4.21 (2.31, 6.49) and 3.12 (1.61, 5.08) μV. CZ leads were 4.81 (2.78, 6.71), 4.15 (2.76, 6.16) and 3.51 (1.75, 5.15) μV. PZ leads were 5.17 (3.03, 6.97), 4.40 (2.89, 6.12) and 3.43 (1.52, 5.34) μV. There were statistically significant differences among the 3 groups (n F=3.29, 14.49, 3.95, 11.73, 14.06, 5.66 and 3.57, n H=18.23, 10.33,18.25; n P=0.027, <0.001, 0.025, <0.001, <0.001, 0.004, 0.042, <0.001, 0.006, <0.001). The peak latency FZ leads of visual P3a wave group N2 were 265.00 (256.00, 286.00), 277.00(260.00,300.00), 282.00(270.00,304.00) ms, respectively. CZ leads weres 274.00(255.00,305.00), 285.00(262.00,329.00), 293.50(270.00,346.00) ms. P3a peak latency FZ leads were (413.83±49.58), (429.83±55.38) and (449.04±54.79) ms, CZ leads were (441.53±61.78), (457.12±69.29) and (460.23±72.24) ms. PZ leads were (430.14±54.53), (462.31±69.2) and (470.02±74.92) ms. N2 amplitude FZ leads were (-6.34±3.13), (-5.72±2.96) and (-4.92±2.05) μV, respectively. Leads P3a amplitude of FZ were 4.00 (2.28, 5.55), 3.15 (2.14, 4.91) and 2.80 (2.19, 4.19) μV. CZ lead were 3.37 (1.98, 4.66), 2.73 (1.70, 3.97) and 2.41 (1.64, 3.45) μV. There were statistically significant differences among the three groups ( n H=13.92, 8.65, 9.17, 10.02, n F=8.18, 6.33, 10.73, 4.62,n P =0.001,0.013,0.010,0.007, <0.001,0.002, <0.001,0.010). Logistic regression analysis showed that alcohol consumption, P3b peak latency and wave amplitude PZ lead, N1 wave amplitude of visual P3a group FZ lead were the influencing factors of MMSE ( n OR=0.04, 1.01, 0.76, 1.51, 95% Cl were 0.00-0.30, 1.00-1.03, 0.59-0.97, 1.08-2.10, n P=0.002,0.007,0.029,0.016).n Conclusion:The peak latency and amplitude of endogenous psychological cognitive potentials N2, P3b and P3a of event-related potentials P3b and P3a in patients with lacunar cerebral infarction were prolonged and decreased. At the same time, with the occurrence of clinical cognitive impairment, the peak latency and amplitude of these cognitive potentials were further prolonged and decreased more significantly. Alcohol consumption, P3b peak latency and PZ lead of visual P3b wave group, and FZ lead of N1 wave of visual P3a wave group were the influencing factors of simple intelligent mental state.