中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2015年
9期
772-775
,共4页
石国美%周俊山%刘宇恺%张红%施洪超%张雷扬%赵红东%唐冰%张颖冬
石國美%週俊山%劉宇愷%張紅%施洪超%張雷颺%趙紅東%唐冰%張穎鼕
석국미%주준산%류우개%장홍%시홍초%장뢰양%조홍동%당빙%장영동
颈动脉狭窄%颈动脉内膜切除术%支架%认知障碍%神经心理学测验
頸動脈狹窄%頸動脈內膜切除術%支架%認知障礙%神經心理學測驗
경동맥협착%경동맥내막절제술%지가%인지장애%신경심이학측험
Carotid stenosis%Endarterectomy,carotid%Stents%Cognition disorders%Neuropsychological tests
目的 比较颈动脉支架置入术(CAS)和颈动脉内膜剥脱术(CEA)对重度颈动脉狭窄患者的认知功能的影响.方法 前瞻性收集216例重度颈动脉狭窄患者,其中接受手术治疗的按治疗方式分为CEA组(n=70)及CAS组(n=76),70例未行手术治疗仅接受药物治疗的患者作为对照组.在其入院24 h内及治疗后3个月测定简易精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)量表及事件相关电位P300,比较各组治疗前后认知功能评分及P300潜伏期的变化,并比较不同治疗方式对认知功能改善程度的差异.结果 术后3个月CEA[MMSE(27.10±1.62)分,MoCA(24.16±1.81)分]和CAS[MMSE(26.70±1.52)分,MoCA(23.58±1.78)分]两组患者认知功能均较术前[分别为MMSE(26.31±1.38)分,MoCA(23.21 ±1.39)分和MMSE(25.95±1.44)分,MoCA(22.85±1.51)分]明显改善,差异有统计学意义(均P=0.000),对照组治疗前后认知功能无明显变化;CEA组患者MoCA评分改善程度[(0.94±0.90)分]及P300潜伏期降低程度[(22.09 ±21.85)ms]均大于CAS组[(0.73±0.78)分、(18.80±25.41) ms],但差异无统计学意义.结论 CEA和CAS是治疗重度颈动脉狭窄相关认知障碍的有效方法,两者改善认知功能疗效相当.
目的 比較頸動脈支架置入術(CAS)和頸動脈內膜剝脫術(CEA)對重度頸動脈狹窄患者的認知功能的影響.方法 前瞻性收集216例重度頸動脈狹窄患者,其中接受手術治療的按治療方式分為CEA組(n=70)及CAS組(n=76),70例未行手術治療僅接受藥物治療的患者作為對照組.在其入院24 h內及治療後3箇月測定簡易精神狀態檢查(MMSE)、矇特利爾認知評估(MoCA)量錶及事件相關電位P300,比較各組治療前後認知功能評分及P300潛伏期的變化,併比較不同治療方式對認知功能改善程度的差異.結果 術後3箇月CEA[MMSE(27.10±1.62)分,MoCA(24.16±1.81)分]和CAS[MMSE(26.70±1.52)分,MoCA(23.58±1.78)分]兩組患者認知功能均較術前[分彆為MMSE(26.31±1.38)分,MoCA(23.21 ±1.39)分和MMSE(25.95±1.44)分,MoCA(22.85±1.51)分]明顯改善,差異有統計學意義(均P=0.000),對照組治療前後認知功能無明顯變化;CEA組患者MoCA評分改善程度[(0.94±0.90)分]及P300潛伏期降低程度[(22.09 ±21.85)ms]均大于CAS組[(0.73±0.78)分、(18.80±25.41) ms],但差異無統計學意義.結論 CEA和CAS是治療重度頸動脈狹窄相關認知障礙的有效方法,兩者改善認知功能療效相噹.
목적 비교경동맥지가치입술(CAS)화경동맥내막박탈술(CEA)대중도경동맥협착환자적인지공능적영향.방법 전첨성수집216례중도경동맥협착환자,기중접수수술치료적안치료방식분위CEA조(n=70)급CAS조(n=76),70례미행수술치료부접수약물치료적환자작위대조조.재기입원24 h내급치료후3개월측정간역정신상태검사(MMSE)、몽특리이인지평고(MoCA)량표급사건상관전위P300,비교각조치료전후인지공능평분급P300잠복기적변화,병비교불동치료방식대인지공능개선정도적차이.결과 술후3개월CEA[MMSE(27.10±1.62)분,MoCA(24.16±1.81)분]화CAS[MMSE(26.70±1.52)분,MoCA(23.58±1.78)분]량조환자인지공능균교술전[분별위MMSE(26.31±1.38)분,MoCA(23.21 ±1.39)분화MMSE(25.95±1.44)분,MoCA(22.85±1.51)분]명현개선,차이유통계학의의(균P=0.000),대조조치료전후인지공능무명현변화;CEA조환자MoCA평분개선정도[(0.94±0.90)분]급P300잠복기강저정도[(22.09 ±21.85)ms]균대우CAS조[(0.73±0.78)분、(18.80±25.41) ms],단차이무통계학의의.결론 CEA화CAS시치료중도경동맥협착상관인지장애적유효방법,량자개선인지공능료효상당.
Objective To compare the effects of carotid endarterectomy (CEA) and carotid artery stenting (CAS) on cognitive function in patients with severe carotid artery stenosis.Methods Two hundreds and sixteen severe carotid artery stenosis patients comprising 70 patients with CEA,76 patients with CAS and 70 controls were recruited consecutively.All of them were subject to the cognitive assessment including Mini-mental State Examination (MMSE),the Chinese version Montreal Cognitive Assessment (MoCA) and event related potential P300 pre-and post-treatment for 3 months.Results During the 3-month follow-up period,patients who underwent CEA (MMSE:27.10 ± 1.62,MoCA:24.16 ± 1.81) or CAS (MMSE:26.70 ± 1.52,MoCA:23.58 ± 1.78) exhibited significant improvements in cognitive function compared with pre-treatment(MMSE:26.31 ± 1.38,MoCA:23.21 ± 1.39;MMSE:25.95 ± 1.44,MoCA:22.85 ± 1.51;all P =0.000).It did not show significant difference in the control group when comparing the pre-with the post-treatment.The improvement in MoCA score and reduction in P300 (ms)incubation in CEA(0.94 ± 0.90,22.09 ± 21.85) seemed more obvious than those iu CAS (0.73-± 0.78,18.80 ± 25.41),although the difference was not statistically significant.Conclusion The findings of this study suggest that both CEA and CAS have a significant effect on cognitive function in patients with severe carotid artery stenosis.
