颈动脉狭窄患者认知功能障碍临床分析Study on the cognitive impairment of patients with carotid artery stenosis
曾庆宏,姜建东,曹金霞,金刚
摘要(Abstract)：
目的探讨颈动脉狭窄与认知功能障碍之间的关系。方法选取颈动脉狭窄组80例和对照组78例,两组患者年龄、性别和文化程度比较差异无统计学意义。所有患者均予颈部MRA及颈动脉彩超检查,并进行MMSE及MoCA评定,同时对脑血管病常见危险因素进行登记。所有数据采用SPSS13.0统计软件进行分析。结果 80例颈动脉狭窄患者均经颈部MRA及血管超声检查证实,其中轻度狭窄32例(40%),中度狭窄26例(32.5%),重度狭窄16例(20%),完全闭塞6例(7.5%)。颈动脉狭窄组无论MMSE还是MoCA评分均小于对照组,差异有统计学意义。随着颈动脉狭窄程度的加重,Mo-CA及MMSE评分越低,两两比较差异有统计学意义(P<0.05)。结论颈动脉狭窄存在认知功能障碍,且随着狭窄程度加重而加重,糖尿病、高血脂、高血压、吸烟是颈动脉狭窄的危险因素。
关键词(KeyWords)： 颈动脉狭窄;认知功能障碍;MoCA
基金项目(Foundation):
作者(Author): 曾庆宏,姜建东,曹金霞,金刚
参考文献(References)：
- [1]Barnett HJ.Carotid disease and cognitive dysfunction[J].AnnIntern Med,2004,140:303-304.
- [2]周振华,陈康宁,周宇,等.可控制狭窄程度的鼠颈动脉狭窄模型建立及认知功能改变[J].中国临床康复,2005,8(28):6052-6 054.
- [3]Kazmierski MK.Stenosis of the carotid arteries[J].Wiad L-ek,2003,56:260-265.
- [4]Derdeyn CP,Videen TO.Compensatory mechanisms for chron-ic cerebral hypoperfusion in patients with tarotid occlusion[J].Stroke,1999,30:1 019-1 024.
- [5]Aart S,Annelies WE,Deverling-Rijinsburger,et al.Late-onsetdementia:structural brain damage and total cerebral blood flow[J].Radiology,2005,236:990-995.
- [6]Moftakhar S,Turk AS,Nieman DB,et al.Effects of carotidorvertebrobasilar stent placement on cerebral perfusion and cog-nition[J].Neuroradiol,2005,26(7):1 772-1 780.
- [7]Bots ML,van Swieten JC,Breteler MM,et al.Cerebral whitematter lesions and atherosclerosis in the Rotterdam Study[J].Lancet,1993,34(1):1 232-1 237.
- [8]Shibata M,Yamasaki N,Miyakawa T,et al.Selective impair-ment of working memory in a mouse model of chronic cerebralhypoperfusion[J].Stroke,2007,38(10):2 826-2 832.
- [9]Schinnidt WP,Roesle A,Krefzschmar K,et al.Functionaland cognitive consequences of silent stroke discovered usedbrain MRI in an elderly population[J].Geriatric,2004,52:1212-1 213.
- [10]Shibata M,Ohtani R,Ihara M,et al.White matter lesions andglial activation in a novel mouse model of chronic cerebral hy-poperfusion[J].Stroke,2004,35(11):2 598-2 603.
- [11]吴宣富,胡顶高.急性缺血性卒中的病理生理学:脑栓塞的新概念[J].国外医学.脑血管疾病分册,1998,6(6):333.
- [12]Grunwald IQ,Supprian T,Politi M,et al.Cognitive changesafter carotid artery stenting[J].Neuroradiology,2006,48:319.
- [13]Aleksic M,Huff W,Hoppmann B,et al.Cognitive functionremains unchanged after endarterectomy of unilateral internalcarotid artery stenosis under local anaesthesia[J].Eur J VascEndovasc Surg,2006,31(6):616-621.
- [14]Borroni B,Tiberio G,Bonardelli S,et al.Is mild vascular cog-nitive impairment reversible?Evidence from a study on theeffect of carotid endarterectomy[J].Neurol Res,2004,26:594-597.
- [15]Petersen RC,Stevens JC,Ganguli M,et al.Practice parame-ter:early detection of dementia:Mild cognitive impairment(anevidence-based review).Report of the Quality Standards Sub-committee of the American Academy of Neurology[J].Neu-rology,2001,56:1 133-1 142.
- [16]Basile AM,Pantoni L,Pracucci G,et al.Age,hypertension,and lacunar stroke are the major determinants of the severityof age-related white matter changes the LADIS(leukoaraiosisand disability in the elderly)study[J].Cerebrovasc Dis,2006,21(5/6):315-322.