摘要
目的探讨颈动脉支架置入术（CAS）对腔隙性脑梗死患者认知功能的影响及相关危险因素。方法采用蒙特利尔认知评价量表（MoCA）、简易精神状态检查（MMSE）分别对43例腔隙性脑梗死患者颈动脉支架置人术前及术后1月、6月、1年、2年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MMSE评分在术前及术后1月、6月，MoCA评分在术前（19．39±2．17）分、术后1月（19．51±1．99）分，复制立方体在术前，交替连线测验、注意、延迟回忆在术前、术后1月，画钟在术前及术后1月、6月均明显降低，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、Mo—CA评分在术后6月、1年、2年，交替连线测验在术后2年，复制立方体、画钟在术后1年、2年，注意、延迟回忆在术后6月、1年、2年均明显升高，差异有统计学意义（P〈0．05或P〈0．01）。在随访2年时Logistic回归分析表明，MoCA评分与患者年龄（OR=50．751，95％C11．407—19．464；P=0．006）、高血压（OR=8．012，95％CI1．212～27．550；P=0．042）、低教育水平（OR=11．586，95％CI 1．164—16．903；P=0．029）有相关性，与糖尿病、CAS无相关性。结论腔隙性脑梗死患者认知功能损害在CAS2年后明显改善，且以视空间功能、注意力、延迟回忆为著，但CAS不是认知功能的独立保护因素，高龄、高血压、低教育水平是其独立危险因素。
Objective To explore the influence of the cognitive function and related dangerous factors in patients lacunar infarction（LI） after carotid artery stenting （CAS）. Methods Neuropsychological tests （ MoCA and MMSE）were conducted in 43 patients with LI before CAS, 1 month,6 months, 1 year and 2 years after CAS and the scores were compared with those of 41 healthy cases. Results Compared with control group, in therapy group,MMSE scores before CAS, 1 month and 6 months after CAS ,MoCA scores before CAS（19.39 ＋2.17） and 1 month after CAS（ 19.51 _＋ 1.99） and the scores of Cube Copying before CAS,Alternating Trail Making Test,at- tention and delayed recall before CAS, 1 month after CAS and Clock Drawing before CAS, 1 month and 6 months after CAS all lowered obviously. There were statistical differences（ P〈 0.05 or P 〈 0.01 ）. Compared with before CAS, in therapy group, MMSE scores and MoCA scores 6 months, 1 year and 2 years after CAS, the scores of Alter- nating Trail Making Test 2 years after CAS, Cube Copying and Clock Drawing 1 year and 2 years after CAS and at- tention and delayed recall 6 months, 1 year and 2 years after CAS all increased obviously. There were statistical differences （ P 〈 0.05 or P〈 0.01 ）. In the follow-up of 2 years ,the result of Logistic Regression Analysis showed that MoCA scores has correlation with age（ OR = 50. 751,95% CI 1. 407 ~ 19. 464 ; P = 0.006）, high blood pres- sure（ 0R=8.012,95% CI1.212 -27.550; P=0.042）and low levels of education（ OR= 11.586,95% CI1. 164 ~ 16. 903; P = 0.029）and no correlation with diabetes and CAS. Conclusion Cognitive impairment in patients with LI is improved 2 years after CAS, and visuospatial function, attention and delayed recall are significantly im- proved. But CAS is not independent protective factors for cognitive functions, and old age,low education levels and high blood pressure are independent risk factors for cognitive impairment in patients with LI.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2013年第7期603-606,共4页
Chinese Journal of Behavioral Medicine and Brain Science
基金
国家“十一五”科技支撑计划课题项目（2006BA101A11）
