摘要：
目的 探讨颈内动脉支架成形术对伴轻度认知损害的无症状性颈内动脉重度狭窄患者认知功能的影响。方法 对2016 年 10 月至 2018 年 9 月住院治疗的 54 例伴轻度认知损害的无症状性颈内动脉重度狭窄（狭窄率 ≥ 70%）患者行颈内动脉支架成形术，分别采用简易智能状态检查量表（MMSE）、连线测验（TMT）和 Stroop 色词测验（SCWT）进行术前 24 h 和术后 1、3、6 个月时的认知功能评价。结果 手术前后 MMSE 评分（P = 0.000），TMT-A 测验时间（P = 0.000）和 TMT-B 测验时间（P = 0.000），SCWT-A 测验时间（P = 0.000）、SCWT-B 测验时间（P = 0.036）和 SCWT-C 测验时间（P = 0.000），以及 SCWT-A 测验正确个数（P = 0.005）差异具有统计学意义。其中，术后 3 和 6 个月时的认知功能（MMSE 评分）和执行功能（TMT-A 和 TMT-B 测验时间，SCWT-A、SCWT-B 和 SCWT-C 测验时间）显著改善（均 P < 0.05），而 SCWT-A 测验正确个数术后3 个月减少（均 P < 0.05）、术后6 个月增加（均 P < 0.05）。结论 颈内动脉支架成形术可以有效改善伴轻度认知损害的无症状性颈内动脉重度狭窄患者的认知功能。
关键词:
颈动脉狭窄,
颈内动脉,
认知障碍,
血管成形术,
支架,
神经心理学测验
Abstract:
Objective To explore effect of internal carotid artery (ICA) stenting on mild cognitive impairment (MCI) of patients with asymptomatic ICA stenosis. Methods Fifty-four patients with severe ICA stenosis (stenosis rate ≥ 70%) from October 2016 to September 2018 were studied. Cognitive function was examined in 54 patients with asymptomatic ICA stenosis 24 h before operation and 1 month, 3 months, 6 months after operation. Cognitive function was assessed with the Mini-Mental State Examination (MMSE), Trail Making Test (TMT) and Stroop Color-Word Test (SCWT). Results There were statistical differences in MMSE (P = 0.000), time of TMT-A and TMT-B (P = 0.000, 0.000), time of SCWT-A, SCWT-B and SCWT-C (P = 0.000, 0.036, 0.000), and correct number of SCWT-A (P = 0.005) before and after ICA stenting. MMSE, time of TMT-A, TMT-B and SCWT-A at 3 and 6 months after stenting were shorter than before and one month after stenting (P < 0.05, for all), while time of SCWT-C was shorter than before stenting (P < 0.05, for all). Time of SCWT-B at 6 months after stenting was shorter than before stenting (P < 0.05, for all). Correct number of SCWT-A at 6 months after stenting was higher than before and 3 months after stenting (P < 0.05, for all), which at 3 monthes after stenting was lower than one month after stenting (P < 0.05, for all). Conclusions ICA stenting can help to improve the MCI patients with asymptomatic ICA stenosis.
Key words:
Carotid stenosis,
Carotid artery, internal,
Cognition disorders,
Angioplasty,
Stents,
Neuropsychological tests
杨志杰, 高宗恩, 张立功, 陈晓辉, 吕在刚, 李大维, 钟孟飞. 支架成形术对伴轻度认知损害的无症状性颈内动脉重度狭窄患者认知功能的影响[J]. 中国现代神经疾病杂志, 2019, 19(10): 743-748.
YANG Zhi-jie, GAO Zong-en, ZHANG Li-gong, CHEN Xiao-hui, Lü Zai-gang, LI Da-wei, ZHONG Meng-fei. Effect of internal carotid artery stenting on mild cognitive impairment of patients with asymptomatic internal carotid artery stenosis[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2019, 19(10): 743-748.