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目的:分析慢性乙醇中毒性周围神经病(CAPN)患者的脑功能损害。方法:以CAPN患者164例为研究组,同期健康志愿者152例为对照组。应用诱发电位技术,分析脑听觉诱发电位(BAEP)、事件相关电位P300;应用脑电超慢涨落技术,分析脑部神经递质相对含量;应用多导睡眠脑电图,评估睡眠状况。结果:1BAEP:CAPN组在波I~VII的潜伏期均显著性延长(t=8.265~18.426,P<0.001),波幅均显著性降低(t=6.398~12.965,P<0.001);2P300:CAPN组在事件相关电位各成分的潜伏期均显著性延长(t=7.929~28.914,P<0.001),波幅均显著性降低(t=18.003~31.736,P<0.001);3神经递质:CAPN组GABA(t=13.873)、GA(t=29.257)显著性增高(P<0.001),5-HT、Ach、NE、DA显著性降低(t=4.904~12.799,P<0.001);4多导睡眠图:CAPN组在记录总时间、睡眠潜伏期、REM潜伏期、醒起时间、醒觉时间、觉醒次数、醒睡比、睡眠S1期比率均显著性偏高(t=4.733~22.958,P<0.001),睡眠总时间、睡眠效率、睡眠维持率、REM周期数,S3期、S4期、REM期比率均显著性偏低(t=8.244~16.000,P<0.001)。结论:CAPN患者在中枢神经系统临床表现出现前,已经存在脑部认知功能异常、神经递质失调及睡眠结构紊乱,神经电生理技术有助于其早期诊断。
PURPOSE: To analyze brain function impairment in patients with chronic alcohol-induced peripheral neuropathy (CAPN). Methods: A total of 164 patients with CAPN were selected as study group and 152 healthy volunteers as control group. The evoked potentials were used to analyze BAEP and event-related potentials (P300). The application of EEG super slowness fluctuation technique was used to analyze the relative content of neurotransmitter in the brain. The polysomnography was used to assess sleep status. Results: The latency of wave I to VII in 1BAEP: CAPN group was significantly prolonged (t = 8.265-18.426, P <0.001), the amplitude was significantly lower (t = 6.398-12.965, P <0.001) (T = 7.929 ~ 28.914, P <0.001), the amplitude was significantly lower (t = 18.003 ~ 31.736, P <0.001); 3 neurotransmitter: CAPN group GABA (t = 13.873) and GA (t = 29.257) (P <0.001), while the levels of 5-HT, Ach, NE and DA were significantly lower (t = 4.904-12.799, P <0.001) The CAPN group had significantly higher total recording time, sleep latency, REM latency, awakening time, awake time, awake times, awake sleep ratio and sleep S1 ratio (t = 4.733-22.958, P <0.001) The total time, sleep efficiency, sleep maintenance rate, REM cycle number, S3, S4, REM ratio were significantly lower (t = 8.244-16.000, P 0.001). Conclusion: Before the clinical manifestations of central nervous system appear in patients with CAPN, cognitive dysfunction, neurotransmitter imbalance and disturbance of sleep structure already exist. Neuroelectrophysiological technique may be helpful for early diagnosis of CAPN.