Davies M G, Rowan M J, MacMathuna P, Keeling P W, Weir D G, Feely J
Department of Pharmacology and Therapeutics, Trinity College Dublin, Ireland.
Hepatology. 1990 Oct;12(4 Pt 1):688-94. doi: 10.1002/hep.1840120412.
Recently many variants of electroencephalogram-evoked responses have been studied as potential diagnostic aids in the detection and evaluation of hepatic encephalopathy. This study assesses the value of the auditory P300 event-related potential--a slow component of the auditory evoked response--as a tool in this field. Twenty-one nonencephalopathic and 12 encephalopathic (grade 1/2) cirrhotic patients and 26 controls were assessed clinically and psychometrically. Electroencephalogram spectral analysis and visual evoked response recordings were also conducted. An auditory P300 wave was elicited using the standard two-tone discrimination paradigm. The latency and amplitude of this wave were measured. The latency of the P300 was found to be significantly increased in the encephalopathic patients compared with both nonencephalopathic cirrhotic and control groups (p less than 0.05). Amplitude of the wave was decreased in both nonencephalopathic and encephalopathic patients, but this was not statistically significant. This study suggests that the latency of the P300 is a good marker of grades 1 and 2 clinical hepatic encephalopathy. The delays in the P300 latency may indicate that encephalopathic patients have a deterioration of their stimulus evaluation abilities.
最近，脑电图诱发反应的许多变体已被研究，作为检测和评估肝性脑病的潜在诊断辅助手段。本研究评估听觉P300事件相关电位（听觉诱发反应的一个慢成分）作为该领域工具的价值。对21名无脑病的肝硬化患者、12名脑病（1/2级）肝硬化患者和26名对照者进行了临床和心理测量评估。还进行了脑电图频谱分析和视觉诱发反应记录。使用标准双音辨别范式诱发听觉P300波。测量该波的潜伏期和波幅。发现脑病患者的P300潜伏期与无脑病的肝硬化患者和对照组相比均显著延长（p<0.05）。无脑病和脑病患者的波幅均降低，但这无统计学意义。本研究表明，P300潜伏期是1级和2级临床肝性脑病的良好标志物。P300潜伏期延长可能表明脑病患者的刺激评估能力下降。
