介入血运重建改善颈动脉次全闭塞伴轻卒中患者认知障碍的研究

doi:10.3877/cma.j.issn.2095-123X.2019.04.009

中华脑科疾病与康复杂志(电子版) ›› 2019, Vol. 09 ›› Issue (04) : 227 -230. doi: 10.3877/cma.j.issn.2095-123X.2019.04.009

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短篇论著

介入血运重建改善颈动脉次全闭塞伴轻卒中患者认知障碍的研究

刘华坤¹, 王鹏¹, 张磊¹, 刘朝来¹, 周亚飞¹, 初建峰¹, 闫中瑞¹, 司翠平¹^,^†(

)

^1. 272011　济宁市第一人民医院神经内科

收稿日期:2019-07-10 出版日期:2019-08-15
通信作者: 司翠平
基金资助:
山东省自然科学基金(ZR2015HL039)

Interventional revascularization improves cognitive impairment in patients with subtotal carotid artery occlusion and mild stroke

Huakun Liu¹, Peng Wang¹, Lei Zhang¹, Chaolai Liu¹, Yafei Zhou¹, Jianfeng Chu¹, Zhongrui Yan¹, Cuiping Si¹^,^†()

^1. Department of Neurology, Jining N0.1 People’s Hospital, Jining 272011, China

Received:2019-07-10 Published:2019-08-15
Corresponding author: Cuiping Si
About author:
Corresponding author: Si Cuiping, Email: 18369895747@126.com

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目的

研究颈内动脉次全闭塞伴有轻卒中患者认知障碍的特点，明确介入颈动脉血运重建对这类患者认知障碍的改善作用。

方法

续贯纳入济宁市第一人民医院神经内科自2016年2月至2019年2月住院的一侧颈动脉次全闭塞伴有轻卒中患者，住院期间完成介入颈动脉血运重建手术，分别在术前和术后3个月接受MMSE评分和MoCA评分检查。

结果

共纳入33例患者，所有患者住院期间成功接受了介入颈动脉血运重建。患者术前33例患者在接受MoCA评分时都提示认知功能下降（19.58±1.54），而MMSE评分未发现有认知功能下降（26.88±0.74）。33例接受介入颈动脉血运重建患者术后3个月的MMSE和MoCA评分较术前均有提高，而且差异具有统计学意义（P<0.05）。

结论

颈内动脉次全闭塞伴有轻卒中患者的认知障碍的特点是MoCA评分较MMSE评分更敏感，能够发现早期认知功能障碍。介入血运重建技术能够改善颈内动脉次全闭塞伴有轻卒中患者的认知功能障碍。

关键词: 轻卒中, 颈动脉次全闭塞, 介入血运重建, 认知障碍

Objective

To study the characteristics of cognitive impairment in patients with subtotal internal carotid artery occlusion accompanied by mild stroke, and to clarify the effect of interventional carotid revascularization on cognitive impairment in these patients.

Methods

Inpatients from February 2016 to February 2019 were included. Carotid artery revascularization was performed in patients with subtotal carotid artery occlusion and mild stroke during hospitalization. All the patients were examined by MMSE and MoCA before and 3 months after operation.

Results

A total of 33 patients were enrolled. All patients underwent successful interventional carotid revascularization during hospitalization. Preoperative MoCA scores showed a decline in cognitive function in 33 patients (mean 19.58±1.54) , while MMSE scores did not show a decline in cognitive function in these patients (mean 26.88±0.74) . The scores of MMSE and MoCA in 33 patients with carotid revascularization after interventional therapy in 3 months were higher than those before operation, and the difference was statistically significant(P<0.05).

Conclusion

MoCA score is more sensitive in assessing cognitive impairment in patients with subtotal internal carotid artery occlusion and mild stroke, and can detect early cognitive impairment.Interventional revascularization can improve cognitive impairment in patients with subtotal internal carotid artery occlusion and mild stroke.

Key words: Mild stroke, Subtotal carotid artery occlusion, Interventional revascularization, Cognitive impairment

表1 纳入患者术前、术后MMSE和MoCA评分的比较

项目		术前	术后3个月	t值	P值
MMSE评分		26.88±0.74	27.67±0.48	-5.136	0.000
MoCA评分		19.58±1.54	20.76±0.94	-3.764	0.000
?	视空间与执行功能	2.67±0.48	3.03±0.47	-3.125	0.003
?	命名	2.36±0.49	2.42±0.50	-0.497	0.621
?	注意	4.03±0.64	4.33±0.65	-1.920	0.059
?	语言	1.52±0.51	1.58±0.50	-0.488	0.627
?	抽象	0.67±0.48	0.76±0.43	-0.807	0.423
?	延迟回忆	2.97±0.73	3.21±0.60	-1.476	0.145
?	定向	5.36±0.74	5.42±0.66	-0.350	0.728

表1 纳入患者术前、术后MMSE和MoCA评分的比较

项目		术前	术后3个月	t值	P值
MMSE评分		26.88±0.74	27.67±0.48	-5.136	0.000
MoCA评分		19.58±1.54	20.76±0.94	-3.764	0.000
?	视空间与执行功能	2.67±0.48	3.03±0.47	-3.125	0.003
?	命名	2.36±0.49	2.42±0.50	-0.497	0.621
?	注意	4.03±0.64	4.33±0.65	-1.920	0.059
?	语言	1.52±0.51	1.58±0.50	-0.488	0.627
?	抽象	0.67±0.48	0.76±0.43	-0.807	0.423
?	延迟回忆	2.97±0.73	3.21±0.60	-1.476	0.145
?	定向	5.36±0.74	5.42±0.66	-0.350	0.728

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