腔隙性脑梗死患者介入治疗术后认知功能变化

The cognitive changes in patients with lacunar infarction after antery-intervention therapy

目的探讨腔隙性脑梗死患者介入治疗术后认知的功能变化特点。方法43例伴颈动脉狭窄的腔隙性脑梗死患者分别于术前及术后1个月、6个月、12个月进行神经心理学测验，并与41例正常人比较。结果与对照组比较，治疗组患者术前简易智能状态检查量表（MMSE）评分[（26．33±1．94）分]、记忆力、执行能力均降低，差异有统计学意义（P〈0．05或P〈0．01）。与术前比较，治疗组患者MMSE评分术后1月[（27．17±2．15）分]、术后6月[（27．78±2．12）分]、术后12月[（28．15±1．98）分]，及记忆力、执行能力大都明显改善，差异有统计学意义（P〈0．05或P〈0．01）。结论腔隙性脑梗死患者急性期（发病1周内）大部分认知功能损害较重，介入治疗12月后大都恢复正常，其机制可能与慢性脑供血不足的改善有关。

Objective To explore the characteristics of the cognitive changes in patients with lacunar in- farction （LI） after carotid artery stenting（CAS）. Methods Neuropsychologieal tests were conducted in 43 pfients with LI and carotid stenosis before and 1 month,6 months, 12 months after CAS and the scores were compared with those of 41 healthy cases. Results Compared with control group, MMSE scores （26.33 ± 1.94） , memory ar,d ex- ecutive function in therapy group lowered obviously. There was statistical difference （P 〈 0.05 or P 〈 0.01 ）. Com- pared with before CAS,MMSE scores of 1 month （27.17 ±2.15） ,6 months （27.17 ±2.15） ,12 months （28.15 ± 1.98 ） after CAS, memory and executive function in therapy group were all better obviously. There was statistical difference （P〈0.05 orP〈0.01）. ConcLusion In acute stage of patients with LI （with in 1 week） ,most cogni- tive impairment was severe. Most cognition disorders was improved to normal level 12 months after CAS. The mechanism may be associated with the improvement of chronic cerebral insufficiency.