颈动脉支架植入术对脑梗死患者认知功能影响
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摘要
目的探讨颈动脉支架植入术对脑梗死患者认知功能的影响。方法选取青海省人民医院自2011年1月至2015年1月收治的110例行颈动脉支架置入术患者为研究对象。术后1、3、6个月应用蒙特利尔认知评价量表(MMSE)以及MoCA量表对患者的认知功能进行评定,采用连线测验(TMT)A、B部分对患者进行认知功能评分。结果与治疗前及治疗后1个月比较,治疗后3、6个月,患者MMSE及MoCA评分逐渐升高,差异均有统计学意义(P<0.05)。与治疗前比较,治疗后1个月TMT-A及TMT-B所需时间明显缩短,治疗后3、6个月检测所需时间进一步缩短,差异均有统计学意义(P<0.05)。治疗后,患者的MoCA各子项得分均有改善,但抽象、回忆以及执行功能的改善较快(P<0.05);定向功能的改善较慢。结论颈动脉支架置入术可以改善无症状性颈动脉狭窄患者的认知功能。
Objective To investigate the effects on the cognitive function of patients with cerebral infarction after carotid artery stent implantation surgery.Methods A retrospective study was performed on 110 cases of patients with cerebral infarction underwent carotid artery stent implantation surgery from January 2011 to January 2015.The cognitive function of the patients was assessed by Montreal cognitive assessment scale(MMSE)and multimedia over Coax Alliance(MoCA)scale at 1,3 and 6 months after surgery,and the cognitive function of the patients was assessed by using part A and part B of trail making test(TMT).Results Compared with before and 1 month after treatment,MMSE and MoCA scores of the patients increased gradually at 3 and 6 months after treatment,and the differences were statistically significant(P<0.05).Compared with that before treatment,the time required for TMT-A and TMT-B at 1 month after treatment was significantly shortened,and the time required for detection at 3 and 6 months after treatment was further shortened(P<0.05).After treatment,scores of all subitems of MoCA of the patients were improved,while the improvement of abstract,recall and executive function was faster(P<0.05).The degree of directed recovery is small.Conclusion Carotid artery carotid stent can significantly improve cognitive function in patients with asymptomatic carotid stenosis and cerebral perfusion.
Objective To investigate the effects on the cognitive function of patients with cerebral infarction after carotid artery stent implantation surgery.Methods A retrospective study was performed on 110 cases of patients with cerebral infarction underwent carotid artery stent implantation surgery from January 2011 to January 2015.The cognitive function of the patients was assessed by Montreal cognitive assessment scale(MMSE)and multimedia over Coax Alliance(MoCA)scale at 1,3 and 6 months after surgery,and the cognitive function of the patients was assessed by using part A and part B of trail making test(TMT).Results Compared with before and 1 month after treatment,MMSE and MoCA scores of the patients increased gradually at 3 and 6 months after treatment,and the differences were statistically significant(P<0.05).Compared with that before treatment,the time required for TMT-A and TMT-B at 1 month after treatment was significantly shortened,and the time required for detection at 3 and 6 months after treatment was further shortened(P<0.05).After treatment,scores of all subitems of MoCA of the patients were improved,while the improvement of abstract,recall and executive function was faster(P<0.05).The degree of directed recovery is small.Conclusion Carotid artery carotid stent can significantly improve cognitive function in patients with asymptomatic carotid stenosis and cerebral perfusion.
引文
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[13] 张尧,李永坤,蔡乾昆,等.颈动脉支架置入术后过度灌注综合征的危险因素分析[J].中华老年心脑血管病杂志,2013,15(2):115-118.
[14] 陈尼卡.颈动脉支架置入后的血流动力学改变[J].中国组织工程研究与临床康复,2008,12(35):6923-6926.
[2] 崔秀英,王雁,肖建廷,等.颈动脉狭窄程度及部位与认知功能障碍的关系[J].临床神经病学杂志,2013,26(1):66-68.
[3] 李菁,韩冰莎,贺迎坤,等.重度颈动脉狭窄腔内支架植入术后认知功能临床研究[J].介入放射学杂志,2015,24(11):943-945.
[4] 贾阳娟,韩凝,王美蓉,等.MoCA与MMSE在急性缺血性卒中后认知障碍评估中的应用[J].中华行为医学与脑科学杂志,2017,26(1):46-50.
[5] 陆骏超,郭起浩,洪震.连线测验(中文修订版)在早期识别阿尔茨海默病中的作用[J].中国临床心理学杂志,2006,14(2):118-120.
[6] 祖国友,苏克江.对重度有症状颈动脉狭窄患者单纯强化药物治疗已足够吗[J].国际脑血管病杂志,2015,6:474-479,480.
[7] 许丽华,陈虹,马婷,等.颈动脉支架置入血管成形术后低血压相关因素分析[J].中国老年学杂志,2010,30(15):2112-2115.
[8] 徐正虎,王君.颈动脉支架置入术后并发症及处理方法[J].中华老年心脑血管病杂志,2015,17(8):837-840.
[9] 王雁,孙涛.颈动脉支架置入患者术后不同时期的认知功能变化[J].中国老年学杂志,2011,31(13):2391-2394.
[10] 刘高飞,李达文,朱敏,等.颈动脉支架置入术中颈动脉窦反应的原因分析及对策[J].中华老年心脑血管病杂志,2013,15(3):328-330.
[11] 李杰,罗香国.颈动脉支架置入术对患者脑灌注影响的研究[J].河北医学,2012,18(9):1205-1209.
[12] 张尧,李永坤,包元飞,等.颈动脉支架置入后脑过度灌注综合征[J].国际脑血管病杂志,2012,20(8):617-620.
[13] 张尧,李永坤,蔡乾昆,等.颈动脉支架置入术后过度灌注综合征的危险因素分析[J].中华老年心脑血管病杂志,2013,15(2):115-118.
[14] 陈尼卡.颈动脉支架置入后的血流动力学改变[J].中国组织工程研究与临床康复,2008,12(35):6923-6926.