CAJ | 학술논문

目的研究无症状性颈动脉狭窄(aCAS)患者接受颈动脉内膜切除术(CEA)对认知功能的影响.方法 26例经脑血管造影检查确诊的aCAS患者按颈动脉狭窄程度分为中度组(1 1例)和重度组(15例),均行CEA治疗.术前及术后6月通过简易精神状况量表(MMSE)、符号-数字模式测验(SDMT)、语言流畅性检验量表(RVR)及听觉词语记忆测验(AVMT)评定认知功能变化.结果术前重度组MMSE、SDWT、RVR及AVMT评分均明显低于中度组[分别为(23.12±3.29)、(25.45±3.06)分,t=2.873、P＜0.05;(11.63±4.11)、(9.35±4.60)分,t=4.716、P＜0.05;(13.84 ±4.02)、(12.15±3.87)分,t=3.960、P＜0.05;(15.60±3.25)、(12.92±3.38)分,=5.058、P＜0.05]；术后中度组MMSE[(25.45±3.06)、(26.24±3.85)分,t=1.681、P＞0.05]及SDMT[(11.63±4.11)、(12.36±4.57)分,t=1.470、P＞0.05]评分无明显变化,但RVR[(13.84±4.02)、(15.25±4.14)分,t=3.067、P＜0.05]及AVMT评分[(15.60±3.25)、(18.53±4.21)分,t=4.892、P＜0.05]明显升高；而重度组MMSE[(23.12±3.29)、(25.90±4.14)分,t=2.780、P＜0.05]、SDMT[(9.35±4.60)、(11.53±4.73)分,t=3.148、P＜0.05]、RVR[(12.15±3.87)、(14.80±4.22)分,t=3.852、P＜0.05]及AVMT评分[(12.92±3.38)、(16.08±4.15)分,t=5.149、P＜0.05]均明显升高.结论 aCAS存在认知功能降低,CEA能解除颈动脉狭窄,改善认知功能障碍.
목적 연구무증상성경동맥협착(aCAS)환자접수경동맥내막절제술(CEA)대인지공능적영향.방법 26례경뇌혈관조영검사학진적aCAS환자안경동맥협착정도분위중도조(1 1례)화중도조(15례),균행CEA치료.술전급술후6월통과간역정신상황량표(MMSE)、부호-수자모식측험(SDMT)、어언류창성검험량표(RVR)급은각사어기억측험(AVMT)평정인지공능변화.결과 술전중도조MMSE、SDWT、RVR급AVMT평분균명현저우중도조[분별위(23.12±3.29)、(25.45±3.06)분,t=2.873、P＜0.05;(11.63±4.11)、(9.35±4.60)분,t=4.716、P＜0.05;(13.84 ±4.02)、(12.15±3.87)분,t=3.960、P＜0.05;(15.60±3.25)、(12.92±3.38)분,=5.058、P＜0.05]；술후중도조MMSE[(25.45±3.06)、(26.24±3.85)분,t=1.681、P＞0.05]급SDMT[(11.63±4.11)、(12.36±4.57)분,t=1.470、P＞0.05]평분무명현변화,단RVR[(13.84±4.02)、(15.25±4.14)분,t=3.067、P＜0.05]급AVMT평분[(15.60±3.25)、(18.53±4.21)분,t=4.892、P＜0.05]명현승고；이중도조MMSE[(23.12±3.29)、(25.90±4.14)분,t=2.780、P＜0.05]、SDMT[(9.35±4.60)、(11.53±4.73)분,t=3.148、P＜0.05]、RVR[(12.15±3.87)、(14.80±4.22)분,t=3.852、P＜0.05]급AVMT평분[(12.92±3.38)、(16.08±4.15)분,t=5.149、P＜0.05]균명현승고.결론 aCAS존재인지공능강저,CEA능해제경동맥협착,개선인지공능장애.
Objective To explore the effects of carotid endarterectomy (CEA) on cognitive function of patients with asymptomatic carotid artery stenosis (aCAS).Methods Twenty-six patients with aCAS diagnosed by digital subtraction angiography were enrolled in this study.All patients were divided into moderate group (n =11) and severe group (n =15).Cognitive functions were examined before and after 6 months CEA.Cognitive function was assessed with the mini-mental status scale (MMSE),symbol-digital mode tests (SDMT),verbal fluency tests Scale (RVR) and auditory verbal memory test (AVMT).The patients' average scores were compared.Results Before surgery,compared with the moderate group,patients in severe group showed significant cognitive decline in MMSE,ADMT,RVR and AVMT ((23.12 ± 3.29) vs.(25.45 ± 3.06),t =2.873,P＜0.05;(11.63 ±4.11)vs.(9.35 ±4.60),t =4.716,P＜0.05;(13.84 ±4.02)vs.(12.15 ±3.87),t=3.960,P＜0.05;(15.60 ± 3.25) vs.(12.92 ±3.38),t =5.058,P ＜0.05).After CEA,in the moderate group,MMSE ((25.45 ± 3.06) vs.(26.24 ± 3.85),t =1.681,P ＞ 0.05) and SDMT ((11.63 ±4.11) vs.(12.36 ± 4.57),t =1.470,P ＞ 0.05) were not significantly different from pre-surgery,but RVR ((13.84±4.02) vs.(15.25 ±4.14),t=3.067,P＜0.05) and AVMT((15.60±3.25) vs.(18.53 ± 4.21),t =4.892,P ＜ 0.05) rated significantly higher; and M MSE ((23.12 ± 3.29) vs.(25.90 ± 4.14),t =2.780,P＜0.05),SDMT((9.35 ±4.60) vs.(11.53 ±4.73),t=3.148,P＜0.05),RVR ((12.15 ±3.87)vs.(14.80±4.22),t =3.852,P＜0.05) and AVMT ((12.92 ±3.38) vs.(16.08 ±4.15),t=5.149,P＜0.05) score were significantly higher in severe group.Conclusion aCAS cause reduced cognitive function,CEA can relieve stenosis and improve cognitive dysfunction.