酒精性精神障碍患者额叶执行功能变化及其临床意义.

Objective To observe changes of the executive function of frontal lobe in patients with alcohol-induced mental disorders and to explore its clinical significance. Methods Twenty-eight patients with alcohol-induced mental disorders were selected as the observation group,and thirty healthy volunteers in the outpatient physical examination of the same hospital were selected as the control group during the same period. All patients in the observation groups were abstaining from alcohol after admission,in the case of withdrawal syndrome,the clonazepam was given for 7 to 10 days. The patients in the control group underwent event-related potentials(P300) and Wisconsin card sorting test(WCST) on the second day,and patients in the observation group received P300 and WCST on admission and at 1 month after treatment; the latency and amplitude of N1,P2,N2,P3 in P300 and the complete classification number(Cc),error response(Re),continuous response(Rp),constant error(Rpe) and conceptual level(Cl%) of WCST related parameters were recorded.The correlation of the subtraction of WCST parameters before and after treatment with P300 parameters was analyzed. Results The latency of N2 and P3 in the observation group was significantly longer than that of the control group,and the wave amplitude of N1,N2,P3 of observation group was significantly lower than that of the control group(P < 0. 05 or P <0. 01). Before the treatment,Cc and Cl% in the WCST of the observation group were significantly lower than those of the control group,while Re,Rp and Rpe were significantly higher than those of the control group(all P < 0. 01). After onemonth treatment,Cc and Cl% of the observation group were significantly higher,and Re was significantly lower than those before treatment(all P < 0. 05). After one-month treatment,Cc,Rp,and Rpe of the observation group were significantly higher than those of the control group,while Cl% was significantly lower than that of the control group(P < 0. 05 or0. 01). In observation group,the subtraction of Rp and Rpe in WCST and the latency of N1 in P300 were positively correlated(r = 0. 591,0. 616,respectively; P < 0. 05),and the subtraction of Cl% in WCST and the latency of N2 in P300 were positively correlated(r = 0. 581,P < 0. 05). Before and after treatment,there was no significant correlation between the subtraction score of WCST parameters and the amplitude of N1,P2,N2,and P3 in P300 of the observation group(all P > 0. 05). Conclusion Patients with alcohol-induced mental disorders exist the executive function impairment of frontal lobe,but the impairment is reversible,the early intervention treatment is of great significance for alleviating the impairment of frontal lobe. [ABSTRACT FROM AUTHOR]