泸州医学院学报
瀘州醫學院學報
로주의학원학보
JOURNAL OF LUZHOU MEDICAL COLLEGE
2007年
6期
464-469
,共6页
陈礼刚%李定君%夏祥国%明扬%刘洛同%刘亮%包长顺%何传斌%韩福刚%陈跃
陳禮剛%李定君%夏祥國%明颺%劉洛同%劉亮%包長順%何傳斌%韓福剛%陳躍
진례강%리정군%하상국%명양%류락동%류량%포장순%하전빈%한복강%진약
药物依赖%事件相关电位%正电子发射断层摄影%磁共振成像%认知障碍
藥物依賴%事件相關電位%正電子髮射斷層攝影%磁共振成像%認知障礙
약물의뢰%사건상관전위%정전자발사단층섭영%자공진성상%인지장애
Drug dependence%Event-related potentials%Positron emission tomography%Magnetic resonance imaging%Cognitive impairment
目的:探讨立体定向毁损术治疗海洛因依赖患者手术前后P300的变化及与脑功能成像的关系.方法:对77例海洛因依赖者立体定向术术前和术后6～12月随访期间应用Keypoint电位仪和PET、fMRI进行检查,评估事件相关电位P300和脑Biography:Chen Ligang(1968-),Male,Professor, Doctor功能成像的变化及其与手术疗效的关系,并与30名正常人比较,进行相关统计学分析.结果:术前海洛因依赖患者及术后随访复吸者P300中的P3波潜伏期延长和波幅降低,与术后未复吸病例和正常对照组相比均存在显著性差异(P＜0.01).P3、PET、fMRI异常术前分别为63例、69例和54例,而随访期间分别为32例、18例和13例,其中,疗效优者异常分别有9例、3例和2例,疗效良者有8例、5例和3例,复吸病例有15例、10例和8例;而且,fMRI异常病例PET和P3均异常,PET异常病例P3均异常.各检查项目术前和随访时比较,及手术疗效优与手术疗效不佳间比较均具有统计意义(P＜0.05).结论:海洛因依赖者存在一定认知障碍和脑功能异常区,定向手术可以改善患者认知功能.手术前后事件相关电位P300和PET、fMRI的改变具有一定相关性并可以作为评估海洛因依赖者手术治疗效果的客观指标.
目的:探討立體定嚮燬損術治療海洛因依賴患者手術前後P300的變化及與腦功能成像的關繫.方法:對77例海洛因依賴者立體定嚮術術前和術後6～12月隨訪期間應用Keypoint電位儀和PET、fMRI進行檢查,評估事件相關電位P300和腦Biography:Chen Ligang(1968-),Male,Professor, Doctor功能成像的變化及其與手術療效的關繫,併與30名正常人比較,進行相關統計學分析.結果:術前海洛因依賴患者及術後隨訪複吸者P300中的P3波潛伏期延長和波幅降低,與術後未複吸病例和正常對照組相比均存在顯著性差異(P＜0.01).P3、PET、fMRI異常術前分彆為63例、69例和54例,而隨訪期間分彆為32例、18例和13例,其中,療效優者異常分彆有9例、3例和2例,療效良者有8例、5例和3例,複吸病例有15例、10例和8例;而且,fMRI異常病例PET和P3均異常,PET異常病例P3均異常.各檢查項目術前和隨訪時比較,及手術療效優與手術療效不佳間比較均具有統計意義(P＜0.05).結論:海洛因依賴者存在一定認知障礙和腦功能異常區,定嚮手術可以改善患者認知功能.手術前後事件相關電位P300和PET、fMRI的改變具有一定相關性併可以作為評估海洛因依賴者手術治療效果的客觀指標.
목적:탐토입체정향훼손술치료해락인의뢰환자수술전후P300적변화급여뇌공능성상적관계.방법:대77례해락인의뢰자입체정향술술전화술후6～12월수방기간응용Keypoint전위의화PET、fMRI진행검사,평고사건상관전위P300화뇌Biography:Chen Ligang(1968-),Male,Professor, Doctor공능성상적변화급기여수술료효적관계,병여30명정상인비교,진행상관통계학분석.결과:술전해락인의뢰환자급술후수방복흡자P300중적P3파잠복기연장화파폭강저,여술후미복흡병례화정상대조조상비균존재현저성차이(P＜0.01).P3、PET、fMRI이상술전분별위63례、69례화54례,이수방기간분별위32례、18례화13례,기중,료효우자이상분별유9례、3례화2례,료효량자유8례、5례화3례,복흡병례유15례、10례화8례;이차,fMRI이상병례PET화P3균이상,PET이상병례P3균이상.각검사항목술전화수방시비교,급수술료효우여수술료효불가간비교균구유통계의의(P＜0.05).결론:해락인의뢰자존재일정인지장애화뇌공능이상구,정향수술가이개선환자인지공능.수술전후사건상관전위P300화PET、fMRI적개변구유일정상관성병가이작위평고해락인의뢰자수술치료효과적객관지표.
Objective: To explore the effects of stereotacticsurgery on event-related potentials (ERP) P300 and its relation to PET (positron emission tomography) and fMRI(functional magnetic resonance imaging) of brain in patients with heroin dependence. Methods: A retrospective study was carried on 77 patients with heroin dependence who were performed stereotacticsurgery. The data which were determined by keypoint potential meter,PET and fMRI at pre-operation and during 1～2 years follows-up were analyzed by statistics. The changes of ERP、MRI and PET as well as operative effect were evaluated and compared with normal control. Results: Compared with normal control and no-relapse cases, the P3 latency was significantly delayed and the P3 amplitude was lower both in pre-operative patients with heroin dependence and the replapser (P＜0.01). There were 63, 69and 45 abnormal cases in ERP, PET and fMRI respectively at pre-operation, and during follow-up period there were 32, 18, 13 cases respectively, among which the cases with excellent therapeutic effect were 9, 3, 2 respectively, with fine therapeutic effect were 8, 5, 3 respectively and 15, 10 and 8 cases respectively in relapser. In addition, when fMRI was abnormal, PET and P3 were also abnormal; the same result was obtained between PET and P3. The comparison between the data of fMRI, PET and P3 in pre-operation and follow-up period, as well as that between the different therapeutic effect groups all have statistics significance(P＜0.05). Conclusion: Cognitive impairment and functional abnormal area in brain were common occurrences in patients with heroin dependence and the cognitive function was improved after stereotacticsurgery. There were moderate correlations between cognitive impairment and functional neroimaging in pre- and post-operative patients with heroin dependence. Furthermore, the P300, PET and fMRI examination are valuable and objective in appraising the surgical effect in patients with heroin dependence.
