无症状性ICA患者行颈动脉支架置入术对认知功能的影响

Effect of carotid artery stenting on the cognitive function in patients with asymptomatic internal carotid artery stenosis

目的探讨颈动脉支架置入术对无症状性颈动脉高度狭窄患者认知功能的影响。方法以本院2012年2月~2014年2月治疗的96例行颈动脉支架置入术的无症状性颈动脉高度狭窄患者为研究组,以同期90例行常规内科治疗的无症状性颈动脉高度狭窄患者为对照组,分别在治疗前3 d和治疗后3个月采用连线测验(TMTa、TMTb)、简易智能量表(MMSE)、阿尔茨海默病评估量表认知部分(ADAS-Cog)评估患者的认知功能。结果研究组患者治疗前3 d颈动脉狭窄为(79.51±6.02)%,治疗后3个月残余狭窄为(13.52±6.01)%,治疗后3个月狭窄程度较治疗前3 d有明显改善(P<0.05);治疗后研究组狭窄程度显著低于对照组(P<0.05)。与治疗前3 d相比,研究组治疗后3个月患者的MMSE评分明显增加(P<0.05),TMTa、TMTb和ADAS-Cog评分均明显降低(P<0.05);治疗3个月研究组各指标均显著优于对照组(P<0.05)。结论颈动脉高度狭窄可能造成患者认知功能损伤,即使是无症状的此类患者,行颈动脉支架置入术对患者的认知功能也具有一定的改善作用,并且可降低颈动脉狭窄程度。

Objective To investigate the effect of carotid artery stenting（CS） on the cognitive function in patients with asymptomatic critical internal carotid artery（ICA）stenosis. Methods In our hospital from Feb- ruary 2012 to February 2014,96 cases of asymptomatic critical ICA stenosis treated with CS were in the experi- mental group, and 90 cases of asymptomatic ICA stenosis with routine medical treatment were selected as the control group. Cognitive function assessments including trail making test A（TMTa） and B（TMTb）, mini-men- tal state examination（MMSE） and Alzheimer＇s disease assessment scale-cognitive subtest（ADAS-Cog） were performed 3 days before and 3 months after CS. Results The preoperative stenosis of ICA （79. 51 ± 6. 02） was significantly different from postoperative residual stenosis （13.52±6. 01）% 3 months after CS （P〈 0. 05）. MMSE score 3 months after CS was significantly higher than that before CS （P〈0.05） ,while TMTa, TMTb and ADAS - cog scores 3 months after CS were markedly lower than those before CS （P〈0. 05）. Con- elusion Asymptomatic critical ICA stenosis may be one factor of cognitive impairment, and the successful CS may improve cognitive function in asymptomatic ICA stenosis.