颈内动脉中重度狭窄患者发生非痴呆性血管性认知功能障碍的危险因素

Risk factors of vascular cognitive impairment with no dementia in patients with moderate to severe internal carotid artery stenosis

目的探讨颈内动脉(ICA)中重度狭窄发生非痴呆性血管性认知功能障碍(VCIND)的危险因素,为临床防治VCIND提供参考依据。方法回顾性分析2017年4-12 月收治的ICA 中重度狭窄患者56例,其中合并VCIND26例,不合并VCIND 30 例。单因素分析两组患者的临床资料,并采用 Logistic回归分析ICA中重度狭窄患者发生VCIND的独立危险因素。结果单因素分析显示年龄、收缩压、脑血管储备、同型半胱氨酸(Hcy)与ICA中重度狭窄患者发生VCIND相关(P<0.05)。Logistic回归分析显示,患者的脑血管储备受损及高Hcy血症是ICA中重度狭窄患者发生VCIND的独立危险因素OR=6.333,3.733, P<0.05)。结论 脑血管储备受损及高Hcy 血症是ICA中重度狭窄患者发生VCIND 的独立危险因素。

Objective To investigate the risk factors of vascular cognitive impairment with no dementia(VCIND) in patients with moderate to severe internal carotid artery(ICA) stenosis, and to provide reference for clinical prevention and treatment of VCIND. Methods A retrospective analysis was made of 56 patients with moderate or severe ICA stenosis admitted from April to December 2017, including 26 with VCIND and 30 without VCIND. The clinical data of the two groups were analyzed by univariate analysis, and the risk factors of VCIND in ICA patients with moderate or severe stenosis were analyzed by Logistic regression. Results Univariate analysis revealed that age, systolic blood pressure, cerebrovascular reserve, homocysteinemia(Hcy) were relative factors of VCIND in patients with moderate to severe ICA stenosis (P < 0.05). Logistic regression analysis showed that the patient's impaired cerebrovascular reserve and hyperhomocysteinemia were independent risk factors for VCIND in patients with moderate to severe ICA stenosis (OR=6.333,3.733,P <0.05). Conclusions Impaired cerebrovascular reserve and hyperhomocysteinemia were independent risk factors for VCIND in patients with moderate to severe ICA stenosis.