摘要
目的：探讨事件相关电位 P300在卒中后抑郁早期筛查和早期干预中的作用。方法选择67例首发脑卒中患者，在病程2周时行汉密尔顿抑郁量表评分，分为轻度 PSD 组（n ＝15）、中度 PSD 组（n ＝11）、重度 PSD 组（n ＝4）和无抑郁组（n ＝37），所有患者均行 P300检查；30例 PSD 患者采用数字表法随机分为两组，氟西汀干预组（n ＝15）和未干预组（n ＝15），病程3个月时再次行 P300检查。结果 PSD 组的 P300潜伏期为（351．30±22．48）ms，与无抑郁组潜伏期（320．92±15．45）ms 比较明显延长，差异有统计学意义（t ＝－6．295，P ＜0．01）；PSD 组的 P300波幅为（5．09±1．47）μV 亦较无抑郁组的（6．47±1．74）μV 明显降低，差异有统计学意义（t ＝3．475，P ＜0．01）。四组间 P300的潜伏期比较差异有统计学意义（F ＝24．484，P ＜0．01），其中中度 PSD 组 P300的潜伏期[（362．73±20．56）ms]与重度 PSD 组 P300潜伏期[（369．75±22．54）ms]均较无抑郁组[（320．92±15．45）ms]和轻度 PSD 组[（338．00±15．70）ms]明显延长，差异均有统计学意义（均 P ＜0．05）。但中度 PSD 组和重度 PSD 组比较，P300潜伏期、波幅差异均无统计学意义（均 P ＞0．05）。使用氟西汀干预组在病程3个月时 P300潜伏期[（326．40±24．42）ms]较治疗前[（356．13±25．76）ms]明显缩短，差异有统计学意义（t ＝5．173，P ＜0．01），与未干预组病程3个月时[（342．07±21．24）ms]比较，差异亦有统计学意义（t ＝2．058，P ＜0．05）。结论 P300可以作为早期筛查诊断 PSD 的客观指标，而早期进行抗抑郁干预治疗，可促进神经功能的恢复，改善 PSD 患者预后。
Objective To explore the role of event -related potential P300 in early diagnosis and treatment of post -stroke depression.Methods Hamilton depression rating scale（HAMD）assessment was adopted to assess 67 patients of first time stroke at 2 weeks.The patients with stroke were divided into four groups：mild post -stroke depression group （n =15）,moderate post -stroke depression group （n =11）,severe post -stroke depression group （n =4）and non -depression group（n =37）.30 patients of post -stroke depression were divided into two groups ran-domly：treatment with fluoxetine 3 months（n =15）and unused anti -depression drugs（n =15）.At 3 months,P300 was executed again in all of patients of post -stroke depression.Results The P300 latency of the patients of the post-stroke depression group[（351.30 ±22.48）ms]was significantly prolonged than the patients of the non -depres-sion group[（320.92 ±15.45）ms]（t =-6.295,P 〈0.01）,and the P300 amplitude of the patients of the post -stroke depression group [（5.09 ±1.47）μV]was also reduced significantly compared with the patients of the non -depression group[（6.47 ±1.74）μV]（t =3.475,P 〈0.01）.The P300 latency among the patients of the four gourps had significant difference（F =24.484,P 〈0.01）.While the means of P300 latency of the patients in the moderate post -stroke depression group[（362.73 ±20.56）ms]and the severe post -stroke depression group[（369.75 ± 22.54）ms]were obviously prolonged than that in the mild post -stroke depression group[（338.00 ±15.70）ms] and the non -depression group[（320.92 ±15.45）ms]（all P 〈0.05）,but there was no difference in the P300 laten-cy between the moderate post -stroke depression group and the severe post -stroke depression group.The mean score of P300 latency after treatment with fluoxetine in the post -stroke depression group[（326.40 ±24.42）ms]was significantly shorten compared with （356.13 ±25.76）ms of before treatment（t =5.173,P 〈0.01）,and also obviously shorten than （342.07 ±21.24）ms of the unused anti -depression drugs group（t =2.058,P 〈0.05）.Conclusion P300 latency and amplitude may be used as an indicator in early diagnosis and treatment of post -stroke depression.
作者
李莉
古美颖
张书琼
Li Li Gu Meiying Zhang Shuqiong(Department of Neurology, Chongqing Three Gorges Central Hospital, Chongqing 404000, Chin)
出处
《中国基层医药》
CAS
2016年第24期3765-3768,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
抑郁
卒中
事件相关电位
P300
氟西汀
Depression
Stroke
Event - related potentials,P300
Fluoxetine
