早期强化认知训练对颈动脉内膜剥脱术后患者认知功能及血清S100β和NSE水平的影响

Effects of early intensive cognitive training on cognitive function and serum S100βand NSE levels in patients with carotid endarterectomy

目的探讨早期强化认知训练对颈动脉内膜剥脱术后患者认知功能及血清S100β和神经元特异性烯醇化酶(NSE)水平的影响。方法选取2017年1月~2019年5月在我院拟行颈动脉内膜剥脱术患者80例,随机分为观察组与对照组,每组各40例。两组均行颈动脉内膜剥脱术。对照组术后予常规治疗,观察组在此治疗基础上予以术后早期强化认知训练,两组均干预2个月。评估并比较两组治疗前后认知功能及血清S100β和NSE水平,并评估其临床疗效。结果干预2个月后,两组MoCA量表及MMSE量表评分均较治疗前明显升高(P<0.05或P<0.01),且观察组升高幅较对照组更明显(P<0.05);治疗2个月后,两组血清S100β与NSE水平均较治疗前明显下降(P<0.05或P<0.01),且观察组下降幅度较对照组更明显(P<0.05)。观察组患者认知功能改善总有效率显著高于对照组(χ2=4.110,P<0.05)。结论早期强化认知训练用于颈动脉内膜剥脱术后患者的临床效果确切,能更改善患者的认知功能,其作用机制可能是通过降低血清S100β与NSE水平,减轻中枢神经系统损伤密切相关。

Objective To explore the effects of early intensive cognitive training on the cognitive function and serum S100βand neuron-specific enolase(NSE)levels in patients with carotid endarterectomy.Methods 80 patients who scheduled to undergo carotid endarterectomy in our hospital from January 2017 to May 2019 were randomly divided into the observation group and the control group,with 40 cases in each group.Carotid endarterectomy was performed in both groups.The control group received conventional treatment after surgery,and the observation group received early postoperative intensive cognitive training based on this treatment.Both groups were intervened for 2 months.The cognitive function and serum S100βand NSE levels before and after treatment in the two groups were assessed and compared,and their clinical efficacy was evaluated.Results After 2 months of intervention,the scores of the montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE)scales in the two groups were significantly higher than those before treatment(P<0.05 or P<0.01),and the increase in the observation group was more significant than that in the control group(P<0.05);After 2 months of treatment,the levels of serum S100βand NSE in the two groups were significantly lower than those before treatment(P<0.05 or P<0.01),and the decline in the observation group was more significant than that in the control group(P<0.05).The total effective rate of improvement of cognitive function in the observation group was significantly higher than that in the control group(χ2=4.110,P<0.05).Conclusion Early intensive cognitive training is effective in patients with carotid endarterectomy and can improve patients'cognitive function.The mechanism may act through reducing serum S100βand NSE levels to reduce central nervous system damage.