支架成形术对伴轻度认知损害的无症状性颈内动脉重度狭窄患者认知功能的影响

Effect of internal carotid artery stenting on mild cognitive impairment of patients with asymptomatic internal carotid artery stenosis

目的探讨颈内动脉支架成形术对伴轻度认知损害的无症状性颈内动脉重度狭窄患者认知功能的影响。方法对2016 年10 月至2018 年9 月住院治疗的54 例伴轻度认知损害的无症状性颈内动脉重度狭窄(狭窄率≥ 70%)患者行颈内动脉支架成形术,分别采用简易智能状态检查量表(MMSE)、连线测验(TMT)和Stroop 色词测验(SCWT)进行术前24 h 和术后1、3、6 个月时的认知功能评价。结果手术前后MMSE 评分(P = 0.000),TMT-A 测验时间(P = 0.000)和TMT-B 测验时间(P = 0.000),SCWT-A 测验时间(P = 0.000)、SCWT?B 测验时间(P = 0.036)和SCWT-C 测验时间(P = 0.000),以及SCWT-A 测验正确个数(P = 0.005)差异具有统计学意义。其中,术后3 和6 个月时的认知功能(MMSE 评分)和执行功能(TMT-A 和TMT-B 测验时间,SCWT-A、SCWT?B 和SCWT-C 测验时间)显著改善(均P < 0.05),而SCWT-A测验正确个数术后3 个月减少(均P < 0.05)、术后6 个月增加(均P < 0.05)。结论颈内动脉支架成形术可以有效改善伴轻度认知损害的无症状性颈内动脉重度狭窄患者的认知功能。

Objective To explore effect of internal carotid artery(ICA) stenting on mild cognitive impairment(MCI) of patients with asymptomatic ICA stenosis.Methods Fifty-four patients with severe ICA stenosis(stenosis rate≥70%) from October 2016 to September 2018 were studied.Cognitive function was examined in 54 patients with asymptomatic ICA stenosis 24 h before operation and 1 month,3 months,6 months after operation.Cognitive function was assessed with the Mini-Mental State Examination(MMSE),Trail Making Test(TMT) and Stroop Color-Word Test(SCWT).Results There were statistical differences in MMSE(P=0.000),time of TMT-A and TMT-B(P=0.000,0.000),time of SCWT-A,SCWT-B and SCWTC(P=0.000,0.036,0.000),and correct number of SCWT-A(P=0.005) before and after ICA stenting.MMSE,time of TMT-A,TMT-B and SCWT-A at 3 and 6 months after stenting were shorter than before and one month after stenting(P<0.05,for all),while time of SCWT-C was shorter than before stenting(P<0.05,for all).Time of SCWT-B at 6 months after stenting was shorter than before stenting(P <0.05,for all).Correct number of SCWT-A at 6 months after stenting was higher than before and 3 months after stenting(P <0.05,for all),which at 3 monthes after stenting was lower than one month after stenting(P <0.05,for all).Conclusions ICA stenting can help to improve the MCI patients with asymptomatic ICA stenosis.