颈动脉狭窄患者认知损害的临床特点研究

The features of cognitive impairment in patients with carotid stenosis

目的了解颈动脉狭窄患者的认知损害特点,并探讨与之相关的可能机制。方法选取91例TIA或小卒中患者作为研究对象,进行TCD和CTA或DSA检查,依据颈动脉狭窄程度将患者分为狭窄组43例(狭窄率≥50%)和对照组48例(狭窄率<50%),采用蒙特利尔认知评估量表(MoCA)对患者进行认知评估,然后对两组患者MoCA总分、子测试得分及相关危险因素进行比较。结果校正性别、年龄、受教育年数、高血压、糖尿病、吸烟和血脂异常因素后,狭窄组患者MoCA总分、执行功能(交替连线试验)、视空间结构功能(复制立方体和画钟)、延迟回忆功能(延迟回忆)方面的测试成绩均低于对照组,差异具有显著性(P<0.05),而命名力、注意力、语言能力、抽象力、定向力,组间差异无显著性(P>0.05)。结论颈动脉狭窄患者存在认知损害,以执行功能、视空间结构功能和延迟回忆功能方面的显著受损为特点。多重血管性危险因素可能促进颈动脉狭窄患者的认知功能减退。

Objective To investigate the features of cognitive impairment in patients with carotid stenosis and expore the related mechanism of cognitive impairment.Methods To select 91 patients who had TIA or minor storke as subjects.According to the severity of carotid stenosis defined by transcranial Doppler and CT angiography or digital subtraction angiography,these patients were divided into the stenosis group(43 patients,stenosis rate≥50%)and the control group(48 patients,stenosis rate<50%).The patients were e...