轻度颅脑损伤患者执行功能障碍研究

摘要

目的 探讨轻度颅脑损伤(mild traumatic brain injury,mTBI)患者伤后执行功能(executive function,EF)的动态变化特点.方法 对63例mTBI患者(研究组)在伤后1周、1个月、3个月和6个月进行执行功能测查,并与60例健康受试者(对照组)比较.测查工具采用连线测验(trail making test,TMTA)、霍普金斯词语学习测验修订版(Hopkins verbal learning test-revised,HVLT-R)、简易视觉记忆测验—修订版(brief visuospatial memo-ry test-revised,BVMT-R)、Stroop色词测验、持续操作测验(continuous performance test,CPT).结果 伤后1周与对照组比较,TMTA、HVLT-R、BVMT-R、Stroop和CPT-IP分值差异有统计学意义(P<0.05);与伤后1周相比,伤后1个月、3个月和6个月时的TMTA分值下降,HVLT-R、BVMT-R、Stroop和CPT-IP分值增加(P<0.05).组内两两比较,伤后1个月与伤后1周比较,TMTA分值下降,BVMT-R、Stroop分值增加(P<0.05);伤后3个月与伤后1个月比较,Stroop、BVMT-R和CPT-IP分值增加(P<0.05);伤后6个月与伤后3个月比较,Stroop和CPT-IP分值增加(P<0.05).结论 mTBI患者在注意能力/警觉性、学习与工作记忆、信息处理速度及执行功能上都可能存在一定的损害,伤后不同时间点恢复速度并不一致.%Objective To explore the executive function in patients with mild traumatic brain injury (mTBI). Methods The evaluation of executive function was conducted in 63 mTBI patients in 1 week, 1, 3 and 6 month after injury and 60 health controls. The executive function was evaluated using Trail Making Test (TMTA), Hopkins Verbal Learning Test-revised (HVLT-R), Brief Visuospatial Memory Test-revised (BVMT-R), Stroop Color Word Tes and Con-tinuous Performance Test (CPT). Results There were significant differences between mTBI patients and controls in TM-TA, HVLT-R, BVMT-R, Stroop Color Word Test and CPT a week following TBI (P<0.05). There were a significant in-crease in scores of TMTA and a significant decrease in HVLT-R, BVMT-R, stroop and CPT-IP at 1, 3 and 6 month compared with 1 week following TBI (P<0.05). There were a significant decrease in TMTA and a significant increase in BVMT-R and stroop 1 month compared with 1 week following TBI (P<0.05). There were a significant increase in stroop, BVMT-R and CPT-IP at 3 month compared with 1 month following TBI (P<0.05). There was a significant increase in stroop and CPT-IP at 6 month compared with 3 month following TBI (P<0.05). Conclusions Patients with mTBI have executive function impairment. The recovery times of different executive function are different in patients with mTBI.