中文摘要：

目的利用脑电非线性分析建立一种客观评价意识障碍程度的方法,探讨意识障碍患者非线性动力学特性的变化规律。方法选取30例伴有意识障碍的卒中患者为意识障碍组,均经临床检查以及脑干听觉诱发电位、躯体感觉诱发电位和常规脑电图进行评估。取30例意识状态正常的脑卒中患者作为对照组。依次采集所有患者安静闭眼、听觉刺激（言语和音乐）和痛觉刺激（患侧和健侧）状态下的脑电信号,并计算其复杂度（Cx）、近似熵（ApEn）和互近似熵（cross-ApEn）非线性指数。结果①意识障碍组和意识正常组在安静闭眼状态下的非线性指数分别为0．25±0．04,0．35±0．08；ApEn为0．54±0．08，0．72±0．12；cross-ApEn为0．69±0．10，0．90±0．11。两组比较差异有统计学意义，均P〈0．01。②在听觉刺激和痛觉刺激的状态下，意识障碍组患者的各项脑电非线性指数与安静闭眼时比较，几乎无变化（Cx：听觉刺激为0．25±0．04，0．26±0．06，痛觉刺激为0．25±0．05，0．26±0．05，P=0．529；ApEn：听觉刺激为0．52±0．10，0．53±0．12，痛觉刺激为0．50±0．11，0．55±0．12，P=0．909；cross—ApEn：听觉刺激为0．69±0．13，0．67±0．16，痛觉刺激为0．66±0．11，0．71±0．12．P=0．605）。意识正常组患者的ApEn和cross—ApEn非线性指数显著增高，但复杂度变化不显著（Cx：听觉刺激为0．37±0．07，0．39±0．08，痛觉刺激为0．37±0．08，0．39±0．07，P=0．205；ApEn：听觉刺激为0．76±0．11，0．79±0．10，痛觉刺激为0．74±0．13，0．81±0．10，P=0．017；cross．ApEn：听觉刺激为0．93±0．10，0．97±0．09，痛觉刺激为0．94±0．13，1．00±0．11，P=0．006）。结论脑电非线性分析能够实时监测和定量检测大脑皮质受抑制的程度。意识障碍患者脑电非线性指数明显低于意识正常者。结合听觉刺激和痛觉?

英文摘要：

Abstract ： Objective To establish an objective method to evaluate the degree of conscious disturbance with EEG nonlinear analysis and to investigate the rule of nonlinear dynamic changes in patients with conscious disturbance after stroke. Methods Thirty patients with stroke complicated with disturbance of consciousness were selected as conscious disturbance group. All of the patients were evaluated by clinical, brainstem auditory evoked potential, somatosensory evoked potential, and routine EEG examination. Thirty patients had stroke with normal conscious state were used as the control group. The EEG signals of all the pa- tients were collected under eyes closed, auditory stimulus （verbal and music ） and painful stimulus （both side） states. Their nonlinear indexes such as complexity （Cx）, approximate entropy （ApEn）, and cross-ap- proximate entropy （cross-ApEn） were calculated. Results （1）The nonlinear indexes under the eyes closed state in the conscious disturbance and control groups were Cx ： 0. 25 ± O. 04 and 0. 35 - 0. 08, ApEn ： 0. 54 ± 0. 08 and 0. 72 ±0. 12, and cross-ApEn： 0. 69 ±0. 10 and 0. 90±0. 11, respectively. There were significant differences between the two groups （all P 〈 0.01 ）. （2）As compared with eyes closed state, all the EEG nonlinear indexes under the auditory stimulus and painful stimulus states in the conscious disturbance group had almost no change （ Cx ： auditory stimulus 0. 25 ± 0. 04 and 0. 26 ± 0. 06, painful stimulus 0. 25 ± 0. 05 and 0. 26 ±0. 05, P = 0. 529） ; ApEn： auditory stimulus 0. 52 ± 0. 10 and 0. 53 ± 0. 12, painful stimulus 0. 50 ±0. 11 and 0. 55 ±0. 12, P =0.9; and cross-ApEn： auditory stimulus 0. 69 ±0. 13 and 0. 67 ±0. 16, painful stimulus 0. 66 ± 0. 11 and 0. 71 ± 0. 12, P = 0. 605 ）. The nonlinear indexes of ApEn and eross-ApEn in the control group were increased significantly, but the changes of Cx were not significantly （ Cx ： auditory stimulus 0. 37 ±0. 07 and 0. 39 ± 0. 08, painful stim