使用事件相关脑电位预测昏迷及其他低反应性患者的预后：一项荟萃分析。
Predicting coma and other low responsive patients outcome using event-related brain potentials: a meta-analysis.
作者信息
Daltrozzo J, Wioland N, Mutschler V, Kotchoubey B
机构信息
Department of Neurology, University Hospital of Strasbourg, France.
出版信息
Clin Neurophysiol. 2007 Mar;118(3):606-14. doi: 10.1016/j.clinph.2006.11.019. Epub 2007 Jan 5.
OBJECTIVE
A meta-analysis was performed to estimate the predictive power (odd ratio, OR) for awakening of auditory event-related potential (ERP) components in low responsive patients with stroke or hemorrhage, trauma, anoxic, post-operative, and metabolic encephalopathy etiologies.
METHODS
We reviewed MEDLINE and analyzed citations for retrieved articles. Logistic regressions were applied on patient samples (Glasgow Coma Scale <12) across and for separate etiologies.
RESULTS
For stroke and hemorrhage the ORs with 95% confidence intervals were: 2.05 [1.12-3.75] (N100), 4.47 [1.92-10.44] (MMN), 10.29 [2.00-52.79] (P300), for trauma: 1.63 [0.70-3.80] (N100), 4.72 [1.35-16.44] (MMN), 12.89 [4.82-34.43] (P300), anoxic: 8.03 [2.83-22.75] (N100), 15.50 [4.27-56.26] (MMN), 5.93 [2.38-14.77] (P300), post-operative: 10.66 [1.98-57.50] (N100), metabolic encephalopathy: 2.12 [0.34-13.13] (N100), 3.60 [0.28-46.36] (MMN), 7.71 [0.75-79.77] (P300), and all etiologies: 2.85 [1.91-4.27] (N100), 6.53 [3.55-12.01] (MMN), and 8.79 [4.88-15.83] (P300). Based on six N100 studies (N=548 patients), five MMN studies (N=470), and six P300 studies (N=313), the N100, MMN, or P300, when present, significantly predicted awakening, P300 and MMN being significantly better predictors than N100.
CONCLUSIONS
The MMN and P300 appear to be reliable predictors of awakening.
SIGNIFICANCE
The prognostic assessment of low responsive patients with auditory ERP should take into account both MMN and P300.
目的
进行一项荟萃分析，以评估听觉事件相关电位（ERP）成分对中风或出血、创伤、缺氧、术后及代谢性脑病等病因导致的低反应性患者苏醒的预测能力（比值比，OR）。
方法
我们检索了MEDLINE并分析检索到的文章的参考文献。对不同病因及各单独病因的患者样本（格拉斯哥昏迷量表<12）应用逻辑回归分析。
结果
对于中风和出血，95%置信区间的OR值为：2.05 [1.12 - 3.75]（N100），4.47 [1.92 - 10.44]（MMN），10.29 [2.00 - 52.79]（P300）；对于创伤：1.63 [0.70 - 3.80]（N100），4.72 [1.35 - 16.44]（MMN），12.89 [4.82 - 34.43]（P300）；缺氧：8.03 [2.83 - 22.75]（N100），15.50 [4.27 - 56.26]（MMN），5.93 [2.38 - 14.77]（P300）；术后：10.66 [1.98 - 57.50]（N100）；代谢性脑病：2.12 [0.34 - 13.13]（N100），3.60 [0.28 - 46.36]（MMN），7.71 [0.75 - 79.77]（P300）；所有病因：2.85 [1.91 - 4.27]（N100），6.53 [3.55 - 12.01]（MMN），8.79 [4.88 - 15.83]（P300）。基于6项N100研究（N = 548例患者）、5项MMN研究（N = 470例）和6项P300研究（N = 313例），当存在N100、MMN或P300时，它们能显著预测苏醒，P300和MMN作为预测指标比N100显著更好。
结论
MMN和P300似乎是苏醒的可靠预测指标。
意义
对低反应性患者进行听觉ERP预后评估时应同时考虑MMN和P300。
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