重度颈动脉狭窄腔内支架植入术后认知功能临床研究

Clinical study of the cognitive function after stent implantation for severe carotid stenosis

目的研究颈动脉支架植入术(CAS)干预治疗重度颈动脉狭窄老年患者认知功能的有效性。方法回顾性收集2008年3月至2012年3月郑州大学人民医院收治的48例重度颈动脉狭窄老年患者(DSA证实颈动脉狭窄程度≥70%)。所有患者接受CAS术干预治疗,根据蒙特利尔认知评估量表(MoCA)评估CAS术前、术后3、6个月认知功能评分。结果 CAS术操作成功率为100%。围手术期内无严重并发症发生。自体对照显示,所有患者术后3、6个月MoCA评分与术前相比明显增高,差异有统计学意义(P<0.05)。结论 CAS术干预治疗可有效改善重度颈动脉狭窄老年患者认知功能,对延缓和阻止认知功能障发展为痴呆状态具有重要意义。

Objective To study the effectiveness of carotid artery stenting （CAS） in improving the cognitive function in elderly patients with severe carotid stenosis. Methods A total of 48 elderly patients with severe carotid stenosis, who were admitted to the People＇s Hospital of Zhengzhou University during the period from March 2008 to March 2012, were enrolled in this study. DSA examination confirmed that the degree of carotid stenosis was ≥70% in all patients. The clinical data were retrospectively analyzed. CAS, used as an intervention therapy for cognitive dysfunction, was carried out in all patients. Montreal cognitive assessment scale （MoCA） was used for the evaluation of the cognitive function before CAS as well as 3 and 6 months after CAS. Results The technical success rate of CAS was 100%. No severe complications occurred during the perioperative period. Self-controlled comparison showed that MoCA scores determined at 3 and 6 months after CAS were significantly higher than those determined before CAS, the differences were statistically significant （P〈0.05）. Conclusion As an intervention therapy, carotid artery stenting can effectively improve the cognitive function for elderly patients with severe carotid stenosis, which is of great significance for postponing and preventing the development of cognitive dysfunction into the dementia status.