闪光视觉诱发电位在鉴别诊断阿尔茨海默病和抑郁性假性痴呆中的作用

摘要

Objective To investigate the functional role of flash visual evoked potential (fVEP) analysis in the differential diagnosis of Alzheimer's disease (AD) with dementia depressive pseudo-dementia (DPD). Methods Mini mental state examination (MMSE) and Hamilton depression scale (HAMD17) were used to evaluate the MMSE and HAMD17 scores of 20 patients with AD, 20 patients with DPD, and 20 healthy controls. The latencies of P2, N2, P3, and N3 waves of fVEP were analyzed. Results MMSE score in AD group was significant lower than those in DPD group and control group (P < 0.05), and HAMD17 score in DPD group was significant higher than those in AD group and control group (P < 0.05 ). The latencies of P2, N2, P3 , and N3 waves were the longest in AD group, and were longer in DPD group than those in control group (P < 0.01 or P < 0.05). The latencies of P2, N2, P3, and N3 waves of fVEP were correlated with MMSE score in AD group, and were correlated with HAMD17 score in DPD group. Conclusion The parameters of fVEP detection between patients with AD and DPD were different, and fVEP was worth popularizing in the differential diagnosis of AD with DPD.%目的:探讨闪光视觉诱发电位(fVEP)检测在鉴别诊断阿尔茨海默病(AD)患者和抑郁性假性痴呆(DPD)中的价值.方法:对可疑的AD、DPD患者及对照组各20例,采用进行简易智力状态检查(MMSE)和17项版本Hamilton抑郁量表(HAMD17)进行MMSE评分和HAMD17评分；分别进行fVEP检测,分别测量闪光刺激诱发电位的P2、N2、P3、N3渡的潜伏期.结果:AD组的MMSE评分均低于DPD组和对照组,差异有统计学意义(P＜ 0.05);DPD组的HAMD17评分均明显高于AD组和对照组,差异有统计学意义(P＜0.05).三组中AD组、DPD组的P2、N2、P3、N3波的潜伏期均较NC组延长,AD组、DPD组及NC组之间差异均有显著意义(P＜0.01).而AD组与DPD组相比,P2、N2、P3、N3波的潜伏期也延长,两组之间差异均有显著意义(P＜0.05).AD组的fVEP各波潜伏期与MMSE评分有关,DPD组的fVEP各波潜伏期与HAMD17评分有关.结论:AD患者和DPD患者闪光视觉诱发电位检测参数不同,fVEP可作为对两者鉴别诊断的辅助方法,具有简便、经济的特点,值得推广.