Evers S, Tepel M, Obladen M, Suhr B, Husstedt I W, Grotemeyer K H, Zidek W
Department of Neurology, University of Münster, Germany.
J Clin Neurophysiol. 1998 Jan;15(1):58-63. doi: 10.1097/00004691-199801000-00007.
Chronic renal failure frequently causes uremic encephalopathy with impairment of different cognitive functions, but the pathophysiology of uremic encephalopathy is still unknown. We measured visually evoked event-related potentials (ERPs) in 33 neurologically asymptomatic patients before and after they underwent hemodialysis and compared their data with those of a strictly age-matched healthy control group. Before hemodialysis, the patients' P3 latency was significantly increased and P3 amplitude was significantly decreased as compared with that of the healthy control group. After hemodialysis, P3 latency of the patients showed a significant decrease (457+/-56 before and 438+/-54 ms after hemodialysis) and the P3 latency habituation during the ERP measurement was also significantly decreased. Patients with higher levels of blood urea nitrogen (BUN), creatinine, and uric acid performed better in ERP measurement than did patients with lower levels. Hemoglobin did not influence ERP latencies and amplitudes. Our data suggest that impaired cognitive processing can be disclosed by ERP even in neurologically asymptomatic chronic renal disease. Removal of uremic toxins by hemodialysis leads to an improvement in cognitive processing.
慢性肾衰竭常导致尿毒症性脑病，伴有不同认知功能受损，但尿毒症性脑病的病理生理学仍不清楚。我们对33例无神经症状的患者在进行血液透析前后测量了视觉诱发电位（ERP），并将他们的数据与严格年龄匹配的健康对照组进行比较。血液透析前，与健康对照组相比，患者的P3潜伏期显著延长，P3波幅显著降低。血液透析后，患者的P3潜伏期显著缩短（血液透析前为457±56毫秒，血液透析后为438±54毫秒），且ERP测量期间的P3潜伏期习惯化也显著降低。血尿素氮（BUN）、肌酐和尿酸水平较高的患者在ERP测量中的表现优于水平较低的患者。血红蛋白不影响ERP潜伏期和波幅。我们的数据表明，即使在无神经症状的慢性肾病患者中，ERP也能揭示认知加工受损。通过血液透析清除尿毒症毒素可改善认知加工。
