支架成形术对重度颈动脉狭窄病人脑灌注及认知功能的影响

Effects of stent angioplasty on cerebral perfusion and cognitive function in patients with severe carotid artery stenosis

目的探讨重度颈动脉狭窄支架成形术后脑灌注和认知功能障碍的变化。方法 2014年1～12月行血管内支架成形术治疗重度(狭窄≥75%)颈动脉狭窄20例。术前5 d、术后3周采用320排螺旋CT评估脑灌注,用蒙特利尔国际认知评估量表(MoCA)评分评估认知功能。结果重度颈动脉狭窄支架成形术后脑灌注指标脑血流量、脑血容量、平均通过时间、达峰时间较术前均明显改善(P<0.05);重度颈动脉狭窄病人术后认知功能MoCA评分[(26.3±2.2)分较从术前5 d[(23.3±1.7)分]明显提高(P<0.05)。结论重度颈动脉狭窄病人存在不同程度低灌注和认知功能障碍,支架成形术可以改善脑灌注,改善病人认知功能。

Objective To study the effects of stent angioplasty on cerebral perfusion and cognitive function in the patients withsevere carotid artery stenosis（sCAS）. Methods The stent angioplasty was performed in 20 patients with sCAS. The cerebral perfusionand cognitive function were assessed by the 320 row CT and the Chinese version of Montreal Cognitive Assessment QuestionnaireCMOCA before and after the stent angioplasty in all the patients, respectively. Results The cerebral blood flow, cerebral blood volume,mean transit time and time to peak after the stent angioplasty of the carotid arteries were significantly improved compared with thosebefore the stent angioplasty in these patients with sCAS（P〈0.05）. The MoCA scores of cognitive function [（26.3 ± 2.2） points] weresignificantly higher after the angioplasty than those [（23.3 ± 1.7） points] before the angioplasty in the patients with sCAS（P〈0.05）.Conclusion The stent angioplasty can significantly improve the cerebral perfusion, and cognitive function in the patients with sCAS.