不同程度无症状颈内动脉狭窄与认知障碍的关系

Relationship between different degrees of asymptomatic carotid artery stenosis and cognitive impairment

目的:探讨不同程度无症状颈内动脉狭窄(ACS)和认知功能障碍的关系。方法:应用中文版蒙特利尔认知评估量表(MoCA)对80例ACS患者和56例对照者进行认知功能评估,比较不同程度的ACS患者的MoCA总分和子项目评分。结果:轻、中、重度ACS患者和对照组间MoCA总评分、视空间与执行功能、注意和延迟回忆测试评分差异有统计学意义(均P<0.05)。轻度ACS患者MoCA总分和子项目评分与对照组间差异无统计学意义(P>0.05),而中、重度ACS患者的MoCA总分、视空间与执行功能、注意测试和延迟回忆评分明显低于对照组和轻度ACS患者,差异均有统计学意义(P<0.05),重度ACS患者的MoCA评分、视空间与执行功能和词语延迟回忆评分亦明显低于中度ACS患者,差异具有统计学意义(P<0.05)。结论:中、重度ACS患者存在认知功能障碍,主要表现为视空间和执行功能、注意力和延迟回忆功能受损。

Objective To investigate relationship between different degrees of asymptomatic carotid artery stenosis and cognitive impairment. Methods The cognitive function were evaluated with the montreal cognitive assessment scale （MoCA） in 80 patients with asymptomatic carotid artery stenosis and 56 controls, the total MoCA scores and subprojects scores were compared between the patients with different degrees of ACS and controls. Results The total MoCA score, visual space and executive function, attention and delayed recall had significant difference among the mild, moderate, severe ACS patients and control group （all P 〈 0.05）. There was no statistical significance of the total MoCA score and the scores of all subprojects between the patients of mild ACS patients and the control group （all P 〉 0.05）. The total MoCA score and the scores of visual space and executive function, attention and delayed recall in moderate and severe ACS patients were significantly lower than the control group and mild ACS patients （P 〈 0.05）. Furthermore, the severe ACS patients, compared with the moderate ACS patients, performed worse on the cognitive tasks which involved visual space and executive function, attention and delayed recall （P 〈 0.05）. Conclusions Cognitive function is impaired in the patients with moderate and severe ACS,the neuropsychological characteristics are mainly impaired in visual space and executive function, attention and delayed recall.