颈动脉狭窄患者认知功能障碍临床分析

Study on the cognitive impairment of patients with carotid artery stenosis

目的探讨颈动脉狭窄与认知功能障碍之间的关系。方法选取颈动脉狭窄组80例和对照组78例,两组患者年龄、性别和文化程度比较差异无统计学意义。所有患者均予颈部MRA及颈动脉彩超检查,并进行MMSE及MoCA评定,同时对脑血管病常见危险因素进行登记。所有数据采用SPSS13.0统计软件进行分析。结果 80例颈动脉狭窄患者均经颈部MRA及血管超声检查证实,其中轻度狭窄32例(40%),中度狭窄26例(32.5%),重度狭窄16例(20%),完全闭塞6例(7.5%)。颈动脉狭窄组无论MMSE还是MoCA评分均小于对照组,差异有统计学意义。随着颈动脉狭窄程度的加重,Mo-CA及MMSE评分越低,两两比较差异有统计学意义(P<0.05)。结论颈动脉狭窄存在认知功能障碍,且随着狭窄程度加重而加重,糖尿病、高血脂、高血压、吸烟是颈动脉狭窄的危险因素。

Objective To assess the correlation of carotid artery stenosis and cognitive impairment.Methods A total of 158 patients were divided into stenotic group（80 patients）and control group（78 patients）,there were no significant significances in ages,sex and education degree in these patients.All the patients were detected by cervical MRA and color Doppler ultrasound,and were tested with a set of neuropsychological scales.Results All the 80 patients with carotid artery stenosis were confirmed by cervical MRA and color Doppler ultrasound,those of patients with mild stenosis were 32 cases,with moderate stenosis were 26 cases,with severe stenosis were 26 cases,and with completely obliteration of carotid artery were 6 cases.The scores of carotid artery stenotic group were less than that of control group in MMSE or MoCA,the significance is significant（P0.01）.Patients with completely obliteration of carotid artery exhibited cognitive impairment,the rate was significantly higher than that in patients with severe,moderate and mild stenosis carotid artery（P0.05）.Conclusion Carotid artery stenosis may lead to cognitive impairment,and the risk is positively correlated to the degree of carotid artery stenosis.Diabetes,hyperlipemia,hypertension,smoking are risk factors of carotid artery stenosis.