脑梗死病人颈动脉粥样硬化与认知功能障碍的关系研究

Relationship between Carotid Atherosclerosis in Patients with Cerebral Infarction and Cognitive Impairment

目的分析并评价脑梗死病人颈动脉粥样硬化与认知功能障碍之间的关系。方法采用MMSE量表对278例脑梗死病人在为期三个月的治疗后实施筛选,再通过韦氏记忆测试量表对神经心理学进行测试,有34例被确诊为认知功能障碍,经匹配性别、左右利手、梗死部位以及梗死药物治疗等后,将其作为观察组,对照组为同期的34例认知功能正常的脑梗死病人。结果观察组和对照组在高血压持续时间、双颈动脉软斑块面积与总面积、颈动脉内膜中层厚度等指标相比差异显著(P<0.05);两组在血糖、胆固醇以及叶酸等生化指标方面比较差异显著(P<0.05)。记忆总智商与双颈动脉斑块总面积和软斑块面积以及颈动脉内膜中层厚度三者呈负相关。结论颈动脉壁斑块的大小与形态是决定急性脑梗死病人三个月后认知功能出现障碍的可能性最高的独立性危险因素。

Objective To analyze and evaluate the relationship between carotid atherosclerosis in patients with cerebral infarction and cognitive dysfunction. Methods 278 patients with cerebral infarction were selected by MMSE scale for 3 months of treatment, among whom 34 cases were diagnosed with cognitive impairment by the neuropsychological measures With wechsler memory scale as the observation group after matching gender, left and right handedness, infarction parts and infarction drug treatment, while 34 contemporaneous cerebral infarction patients with normal cognitive function were regarded as the control group. Results The differences of the index such as hypertension duration time, the soft plaque area and total area of double carotid artery and carotid artery intima-media thickness had statistical significance （P 〈0.05） between the two groups; the differences of the index such as blood glucose, cholesterol and folio acid had statistical significance （P 〈0.05）between the two groups. The memory oflQ had negative correlation with soft plaque area and total area of double carotid artery, carotid artery intima-media thickness. Conclusions The plaque size and shape of carotid artery wall are the highest independence risk factors to decide the possibility of cognitive function obstacle of acute cerebral infarction patients after three months.