无症状颈动脉粥样硬化斑块稳定性与认知功能的关系

Relationship between stability of asymptomatic carotid atherosclerotic plaque and cognitive function

目的本研究探讨40岁及以上无症状颈动脉粥样硬化斑块人群中斑块稳定性与认知功能减退的关系。方法选取2015年9月至2017年9月期间参加中国国家卒中高危人群筛查和干预项目(China National Stroke Screen Survey,CNSSS)且隶属北京市昌平区北七家社区卫生服务中心及顺义区空港医院筛查点的人群为研究对象。采用颈部血管超声评价颈动脉斑块稳定性、蒙特利尔认知评定量表-北京版评价认知功能。使用Logistic回归来分析二者的关系。结果共有1446例患有颈动脉斑块、数据齐全受试者纳入本研究。多因素Logistic回归结果显示与稳定斑块相比,不稳定斑块是认知功能减退的危险因素(OR=1.255,95%CI:1.002~1.571)。结论相较于稳定斑块,无症状颈动脉粥样硬化不稳定斑块增加认知减退风险,临床上需要提高对不稳定斑块患者的管理,以预防和延缓认知功能减退。

Objective To investigate the relationship between stability of asymptomatic carotid atherosclerosis plaque and cognitive function in population over the age of 40.Method Participants in Beiqijia community(Changping District,Beijing)and Konggang community(Shunyi District,Beijing)who took part in the China National Stroke screen Survey(CNSSS)from September 2015 to September 2017 were included.Ultrasound was used to examine carotid plaque stability,and the Montreal Cognitive Assessment-Beijing version was used to assess cognitive function.The association between carotid plaque stability and cognitive impairment was assessed by using Logistic regression analysis.Result A total of 1446 participants with carotid plaques and complete data were enrolled.Logistic regression analysis showed that compared with stable plaque,unstable plaque was related with cognitive impairment,with a multivaraite-adjusted OR of 1.255(95%confidence interval 1.002-1.571).Conclusion Compared with stable plaque,asymptomatic unstable carotid atherosclerotic plaque is associated with cognitive impairment.Management of unstable plaque is critical for prevention and delay of cognitive deterioration.