颈动脉狭窄患者支架置入与认知功能改善相关性的研究

发布时间：2018-05-08 14:00

本文选题：颈动脉狭窄 + 血管内支架置入术　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]探讨颈动脉狭窄患者支架置入术与认知功能改善的相关性,分析颈动脉支架置入影响颈动脉狭窄患者认知功能的机制,为今后颈动脉狭窄患者认知功能障碍的防治提供依据。[方法]1.收集2014年10月1日到2016年4月10日在昆明医科大学第二附属医院神经外科及脑血管病科住院的颈内动脉狭窄患者36例。2.入院后对36例患者行头颅MRI检查或CT检查及DSA检查确诊为颈内动脉狭窄,狭窄程度50%为研究对象。收集患者的一般资料,包括性别、年龄、文化程度、吸烟史、饮酒史、高血压病史、糖尿病史等。将36例患者分为颈动脉支架置入术治疗组(23例)和对照组(13例),对照组以采用药物保守治疗为主。3.依据蒙特利尔认知评分量表(MoCA)对所有患者在治疗前、治疗后6个月、治疗后12个月分别进行评分,计算出每位研究对象的量表总分及每个子项目的得分。4.采用SPSS17.0统计软件分析所得数据。计数资料以相对数构成比(%)表示,两样本间或组内治疗前后各项目评分均值比较采用χ2检验,计量资料以均数士标准差(χ ±s)表示,两样本均数间比较采用t检验,以P0. 05为差异有统计学意义。[结果] 1.治疗组与对照组患者一般情况及相关血管危险因素比较,如年龄、性别、文化程度、吸烟史、高血压病史、糖尿病史、高脂血症等方面差异无统计学意义(P0. 05)。2.23例颈动脉支架置入术患者在治疗后MoCA量表总分及视空间与执行功能、注意力、延迟回忆力等项目均较治疗前明显改善,差异有统计学意义(P0.05),而13例仅药物保守治疗的对照组患者,治疗前、治疗后6个月、治疗后12个月MoCA量表总分及各评分项目均改善不明显,差异无统计学意义(P0. 05)。3.治疗组与对照组患者比较,治疗后6个月MoCA量表评分中治疗组的总分及视空间与执行功能、延迟回忆力较对照组改善明显,差异有统计学意义(P0. 05),治疗后12个月的总分及视空间与执行功能、命名能力、注意力、延迟回忆力较对照组改善明显,差异有统计学意义(P0. 05)。[结论]1.对于狭窄程度50%的颈动脉狭窄患者,颈动脉支架置入术能明显改善患者的认知功能,尤其是视空间与执行功能、注意力、延迟回忆力。2.颈动脉支架置入术患者较单纯药物保守治疗患者能明显改善认知功能,在治疗后6个月在视空间与执行功能、延迟回忆力方面改善明显,治疗后12个月在视空间与执行功能、命名能力、注意力、延迟回忆力方面改善明显。
[Abstract]:[objective] to investigate the correlation between stenting and cognitive function improvement in patients with carotid artery stenosis, and to analyze the mechanism of carotid stenting affecting cognitive function in patients with carotid artery stenosis. To provide evidence for the prevention and treatment of cognitive dysfunction in patients with carotid artery stenosis. [methods] 1. From October 1, 2014 to April 10, 2016, 36 patients with internal carotid artery stenosis in Department of Neurosurgery and Cerebrovascular Disease, second affiliated Hospital of Kunming Medical University, were collected. After admission, 36 patients were diagnosed as internal carotid artery stenosis by MRI or CT or DSA. The degree of stenosis was 50%. Collect general data of patients, including gender, age, education, smoking history, alcohol history, hypertension history, diabetes history, etc. Thirty-six patients were divided into two groups: the carotid stenting group (n = 23) and the control group (n = 13). According to the Montreal Cognitive scale (MOCA), all the patients were scored before treatment, 6 months after treatment and 12 months after treatment. The total score of each study object and the score of each sub-item were calculated. The data were analyzed by SPSS17.0 software. The counting data were expressed as relative number composition ratio. 蠂 2 test was used to compare the mean scores of each item before and after treatment between the two samples or within the group. The measured data were expressed as the mean standard deviation (蠂卤s), the mean values of the two samples were compared with t test and P0 respectively. The difference was statistically significant. [result] 1. There was no significant difference between the treatment group and the control group in general condition and related vascular risk factors, such as age, sex, education level, smoking history, hypertension history, diabetes history, hyperlipidemia and so on. After treatment, the total score of MoCA scale, visual space and executive function, attention and delayed recall were significantly improved in patients with carotid stenting. The difference was statistically significant (P 0.05), but there was no significant improvement in the total scores and scores of MoCA scale before treatment, 6 months after treatment and 12 months after treatment in 13 cases of control group treated only with conservative drug therapy, and there was no significant difference between them (P 0. 0). 05. 3. Compared with the control group, the total score, visual space and executive function of the treatment group were significantly improved compared with the control group in the MoCA scale score 6 months after treatment, and the difference was statistically significant (P0). The total score, visual space and executive function, naming ability, attention and delayed recall were significantly improved in 12 months after treatment compared with control group (P 0. 0). 05. [conclusion] 1. For 50% of patients with carotid artery stenosis, carotid stenting can significantly improve cognitive function, especially visual space and executive function, attention, delayed recall. The cognitive function of the patients treated with carotid artery stenting was significantly improved than that of the patients treated with conservative drug therapy, the visual space and executive function were significantly improved at 6 months after treatment, the delayed recall was significantly improved, and the visual space and executive function were improved 12 months after treatment. Naming ability, attention, and delayed recall improved significantly.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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