颈动脉支架置入术对重度颈动脉狭窄患者认知功能的影响

Effect of carotid artery stenting on cognitive function in patients with severe carotid artery stenosis

目的探讨颈动脉支架置入术(carotid artery stenting,CAS)对重度颈动脉狭窄患者认知功能的影响。方法连续选取2019年1月至2020年12月在亳州市人民医院神经内科就诊的重度(狭窄程度≥70%)颈动脉狭窄患者。根据治疗方案不同,将所有患者分为CAS组和对照组。CAS组接受CAS联合最佳药物治疗,对照组仅采用最佳药物治疗。在治疗前以及治疗后6个月采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评价患者认知功能。结果研究期间纳入重度颈动脉狭窄患者52例,CAS组37例,对照组15例。2组人口统计学和基线临床资料均无统计学差异。CAS组所有患者均顺利完成CAS,无手术并发症。CAS组治疗6个月后MoCA评分较治疗前显著提高(P<0.001),而对照组则不然。组间比较显示,CAS组和对照组患者治疗前MoCA评分差异无统计学意义;治疗后6个月随访,CAS组MoCA评分显著高于对照组(P=0.007)。结论CAS可改善重度颈动脉狭窄患者术后短期认知功能。

Objective To investigate the effect of carotid artery stenting(CAS)on cognitive function in patients with severe carotid artery stenosis.Methods From January 2019 to December 2020,consecutive patients with severe carotid artery stenosis(stenosis degree≥70%)treated in the Department of Neurology,Bozhou People's Hospital were selected.According to different treatment schemes,all patients were divided into a CAS group and a control group.The CAS group received CAS combined with the best drug treatment,while the control group only received the best drug treatment.The cognitive function was evaluated by Montreal Cognitive Assessment(MoCA)before treatment and at 6 months after treatment.Results During the study,52 patients with severe carotid artery stenosis were enrolled,including 37 patients in the CAS group and 15 in the control group.There were no significant differences in demographic and baseline clinical data between the two groups.All patients in the CAS group completed procedure successfully without any complications.MoCA score in the CAS group was significantly higher than that before treatment(P<0.001),but not in the control group.There was no significant difference in MoCA score between the patients in the CAS group and the control group before treatment;the MoCA score in the CAS group was significantly higher than that in the control group at 6 months after treatment(P=0.007).Conclusion CAS may improve the short-term postoperative cognitive function of patients with severe carotid artery stenosis.