颈动脉狭窄与轻度认知功能障碍关系探讨
发布时间：2018-10-19 14:49
【摘要】：目的使用DSA或CTA对患者颈动脉狭窄程度进行分级诊断,探讨颈动脉狭窄分级及部位与患者轻度认知功能障碍的关系。 方法采用简易智能精神状态量表(MMSE)、蒙特利尔量表(MoCA)、临床痴呆量表(CDR)、日常生活能力量表(ADL)、汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)等神经心理学量表对经DSA或CTA证实的168例颈动脉狭窄的患者(狭窄组)和79例颈动脉无狭窄患者(对照组)进行认知功能评估。所有研究对象均由DSA或CTA对颈动脉狭窄程度评估分级。按照北美症状性颈动脉内膜剥脱术试验协作组狭窄程度分级(NASCET分级)：轻度狭窄(狭窄率30%)、中度狭窄(狭窄率30%-69%),重度狭窄(狭窄率70%-100%),对神经心理学测评得分和血管评估分级结果进行相关性分析。 结果狭窄组患者综合认知测评得分较对照组得分低,结果存在统计学差异(p0.05)。其中,颈动脉中度狭窄组、重度狭窄组患者综合认知测评得分与对照组相比显著降低,差异有统计学意义(p0.05)；轻度狭窄组综合认知测评得分较对照组得分低,但差异无统计学意义(p0.05)；中度颈动脉狭窄组与轻度颈动脉狭窄组、重度颈动脉狭窄组与中度颈动脉狭窄组比较,综合认知测评较上一级组得分低,差异有统计学意义(p0.05)；左侧颈动脉狭窄组患者的计算力、语言流畅性评分显著低于对照组患者,右侧颈动脉狭窄组患者画钟及延迟回忆测验分数均显著低于对照组患者,差异有统计学意义(P0.05)。 结论 1.中-重度颈动脉狭与轻度认知功能障碍明显相关,随颈动脉狭窄程度增加,认知功能损害加重。 2.左侧颈动脉中一重度狭窄患者以计算力、语言能力受损为显著,右侧颈动脉中一重度狭窄患者以执行功能、视空间结构及延迟回忆受损为显著。
[Abstract]:Objective to investigate the relationship between carotid stenosis and mild cognitive impairment (MCI) in patients with carotid artery stenosis by using DSA or CTA. Methods (MMSE), Montreal scale, (MoCA), clinical dementia scale, (CDR), activity of daily living scale, (ADL), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the changes of neuropsychological scale, such as DSA or CTA, by using simple mental state scale (MMSE), Montreal scale (MoCA), scale), and clinical dementia scale (CDR), scale). Cognitive function was evaluated in 168 patients with carotid artery stenosis (stenosis group) and 79 patients without carotid artery stenosis (control group). All subjects were graded by DSA or CTA for carotid artery stenosis. According to the NASCET classification of the North American symptomatic carotid endarterectomy test group, mild stenosis (30%), moderate stenosis (30 -69%), severe stenosis (70 -100%), neuropsychological assessment and blood use were performed on the basis of the classification of stenosis (30%), moderate stenosis (30% -69%) and severe stenosis (70% -100%). The correlation analysis of the grading results was carried out. Results the scores of comprehensive cognitive assessment in patients with stenosis were lower than those in control group (p0.05). The scores of comprehensive cognitive assessment in patients with moderate carotid artery stenosis and severe stenosis were significantly lower than those in control group (p0.05), and the scores of comprehensive cognitive assessment in mild stenosis group were lower than those in control group. But there was no significant difference (p0.05), the scores of comprehensive cognitive test in moderate carotid artery stenosis group and mild carotid artery stenosis group, severe carotid artery stenosis group and moderate carotid artery stenosis group were lower than those in the upper class group (p0.05). The score of computational power and language fluency in the left carotid artery stenosis group was significantly lower than that in the control group, and the score of clock drawing and delayed recall test in the right carotid artery stenosis group was significantly lower than that in the control group (P0.05). Conclusion 1. Moderate to severe carotid stenosis was significantly associated with mild cognitive impairment, and cognitive impairment increased with the increase of carotid stenosis. 2. In the patients with moderate to severe stenosis of left carotid artery, the ability of calculation and speech were significantly impaired, while the patients with moderate to severe stenosis of right carotid artery were impaired by executive function, visual spatial structure and delayed recall.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.16
本文编号：2281460
[Abstract]:Objective to investigate the relationship between carotid stenosis and mild cognitive impairment (MCI) in patients with carotid artery stenosis by using DSA or CTA. Methods (MMSE), Montreal scale, (MoCA), clinical dementia scale, (CDR), activity of daily living scale, (ADL), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the changes of neuropsychological scale, such as DSA or CTA, by using simple mental state scale (MMSE), Montreal scale (MoCA), scale), and clinical dementia scale (CDR), scale). Cognitive function was evaluated in 168 patients with carotid artery stenosis (stenosis group) and 79 patients without carotid artery stenosis (control group). All subjects were graded by DSA or CTA for carotid artery stenosis. According to the NASCET classification of the North American symptomatic carotid endarterectomy test group, mild stenosis (30%), moderate stenosis (30 -69%), severe stenosis (70 -100%), neuropsychological assessment and blood use were performed on the basis of the classification of stenosis (30%), moderate stenosis (30% -69%) and severe stenosis (70% -100%). The correlation analysis of the grading results was carried out. Results the scores of comprehensive cognitive assessment in patients with stenosis were lower than those in control group (p0.05). The scores of comprehensive cognitive assessment in patients with moderate carotid artery stenosis and severe stenosis were significantly lower than those in control group (p0.05), and the scores of comprehensive cognitive assessment in mild stenosis group were lower than those in control group. But there was no significant difference (p0.05), the scores of comprehensive cognitive test in moderate carotid artery stenosis group and mild carotid artery stenosis group, severe carotid artery stenosis group and moderate carotid artery stenosis group were lower than those in the upper class group (p0.05). The score of computational power and language fluency in the left carotid artery stenosis group was significantly lower than that in the control group, and the score of clock drawing and delayed recall test in the right carotid artery stenosis group was significantly lower than that in the control group (P0.05). Conclusion 1. Moderate to severe carotid stenosis was significantly associated with mild cognitive impairment, and cognitive impairment increased with the increase of carotid stenosis. 2. In the patients with moderate to severe stenosis of left carotid artery, the ability of calculation and speech were significantly impaired, while the patients with moderate to severe stenosis of right carotid artery were impaired by executive function, visual spatial structure and delayed recall.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.16
【参考文献】
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1 满育平;马隆佰;刘颖;梁千里;韩松苡;;非增强MRA和CTA在颈内动脉狭窄的临床诊断价值[J];放射学实践;2013年04期
，本文编号：2281460
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