Buoncristiani U, Alberti A, Gubbiotti G, Mazzotta G, Gallai V, Quintaliani G, Gaburri M
Nephrology Unit, Ospedale Silvestrini S. Andrea delle Fratte, Perugia, Italy.
Perit Dial Int. 1993;13 Suppl 2:S202-5.
We employed the so-called event-correlated potential (ECP) P300, a neurophysiological test which explores the circuits of attention and memory in the brain and is altered in subjects with a dismetabolic or degenerative encephalopathy, in order to evaluate the cognitive faculty in two groups of uremic patients [18 on continuous ambulatory peritoneal dialysis (CAPD), 15 on hemodialysis (HD)] comparable with respect to age and time on dialysis. The values of latency (msec) of P300 resulted in CAPD patients 356 +/- 26 in CZ (central zero electrodes) and 357.5 +/- 25 in PZ (parietal zero electrodes), not significantly different from the values in normal controls (341 +/- 14.5 in CZ and 340 +/- 15.6 in PZ) and in HD patients postdialysis (354 +/- 24.4 in CZ and 354 +/- 25.6 in PZ). On the contrary, the predialytic values of HD patients (384 +/- 25.6 CZ and 385 +/- 25.5 in PZ) were significantly different from the postdialytic values and from the values of CAPD patients and controls (p < 0.01). These results support the conclusion that HD is able to restore a normal cognitive faculty only transiently in the postdialytic phase, while CAPD maintains this important function steadily close to the normal range, thus being clearly better than HD.
我们采用了所谓的事件相关电位（ECP）P300，这是一种神经生理学测试，用于探索大脑中的注意力和记忆回路，并且在患有代谢紊乱或退行性脑病的受试者中会发生改变，目的是评估两组年龄和透析时间相当的尿毒症患者的认知能力[18例持续性非卧床腹膜透析（CAPD）患者，15例血液透析（HD）患者]。P300的潜伏期（毫秒）值在CAPD患者中，CZ（中央零电极）处为356±26，PZ（顶叶零电极）处为357.5±25，与正常对照组（CZ处为341±14.5，PZ处为340±15.6）以及HD患者透析后的数值（CZ处为354±24.4，PZ处为354±25.6）无显著差异。相反，HD患者透析前的值（CZ处为384±25.6，PZ处为385±25.5）与透析后的值以及CAPD患者和对照组的值有显著差异（p<0.01）。这些结果支持以下结论：HD仅在透析后阶段能短暂恢复正常认知能力，而CAPD能将这一重要功能稳定维持在接近正常范围，因此明显优于HD。
