CAJ | 학술논문

目的：探讨无症状性单侧重度颈内动脉狭窄（ICAS）患者认知功能障碍的临床特点。方法回顾性分析经DSA诊断的无症状性单侧重度ICAS（狭窄率≥70％）患者80例及无颈动脉狭窄者40例（对照组），依据狭窄侧别将重度ICAS 患者分为左侧狭窄组和右侧狭窄组，各40例。采用北美症状性颈动脉内膜切除协作研究组标准对狭窄程度进行分级，采用蒙特利尔认知评估量表（ MoCA）对患者认知功能进行评价，并对3组患者认识功能进行分析。结果左右侧狭窄组患者MoCA总分、视空间与执行功能、语言能力、延迟记忆力评分均低于对照组，差异均有统计学意义[左侧狭窄组分别为（21.8±3.1）、（3.4±1.3）、（1.8±0.6）、（1.6±1.3）分，右侧狭窄组分别为：（22.6±2.5）、（3.5±1.1）、（1.9±0.6）、（1.7±1.4）分，对照组分别为：（26.4±1.8）、（4.2±0.9）、（2.7±0.6）、（3.8±1.0）分；均P ＜0.01]，命名、注意力、抽象能力、定向力评分与对照组比较，差异均无统计学意义（均P ＞0.05）。左侧狭窄组患者MoCA总分及各单项测试评分与右侧狭窄组患者比较，差异均无统计学意义（均P ＞0.05）。结论无症状性单侧重度ICAS患者普遍存在认知功能障碍，以延迟记忆力、视空间与执行功能和语言功能受损为特点。
목적：탐토무증상성단측중도경내동맥협착（ICAS）환자인지공능장애적림상특점。방법회고성분석경DSA진단적무증상성단측중도ICAS（협착솔≥70％）환자80례급무경동맥협착자40례（대조조），의거협착측별장중도ICAS 환자분위좌측협착조화우측협착조，각40례。채용북미증상성경동맥내막절제협작연구조표준대협착정도진행분급，채용몽특리이인지평고량표（ MoCA）대환자인지공능진행평개，병대3조환자인식공능진행분석。결과좌우측협착조환자MoCA총분、시공간여집행공능、어언능력、연지기억력평분균저우대조조，차이균유통계학의의[좌측협착조분별위（21.8±3.1）、（3.4±1.3）、（1.8±0.6）、（1.6±1.3）분，우측협착조분별위：（22.6±2.5）、（3.5±1.1）、（1.9±0.6）、（1.7±1.4）분，대조조분별위：（26.4±1.8）、（4.2±0.9）、（2.7±0.6）、（3.8±1.0）분；균P ＜0.01]，명명、주의력、추상능력、정향력평분여대조조비교，차이균무통계학의의（균P ＞0.05）。좌측협착조환자MoCA총분급각단항측시평분여우측협착조환자비교，차이균무통계학의의（균P ＞0.05）。결론무증상성단측중도ICAS환자보편존재인지공능장애，이연지기억력、시공간여집행공능화어언공능수손위특점。
Objective To investigate the clinical characteristics of cognitive impairment in the patients with asymptomatic unilateral severe internal carotid artery stenosis (ICAS). Methods A total of 80 patients with unilateral severe carotid stenosis (stenosis rate ≥70%)and 40 patients without carotid stenosis (control group)diagnosed by digital substract angiography (DSA)were analyzed retrospectively. According to the stenotic sides,the patients with severe ICAS were divided into a left stenosis group and a right stenosis group (n = 40 in each group). The North American Symptomatic Carotid Endarterectomy Trial (NASCET)criteria were used to grade the degree of stenosis. Montreal cognitive assessment (MoCA)was used to evaluate the cognitive function of the patients,and then the cognitive function of the patients in 3 groups was assessed. Results The MoCA total scores,visuospatial and executive functions,and language ability,and delayed memory scores of the patients in both left and right groups were lower than those of the control group. There were significant differences (21. 8 ± 3. 1,3. 4 ± 1. 3,1. 8 ± 0. 6,and 1. 6 ± 1. 3,respec-tively in the left stenosis group;22. 6 ± 2. 5,3. 5 ± 1. 1,1. 9 ± 0. 6,and 1. 7 ± 1. 4,respectively in the right stenosis group;and 26. 4 ± 1. 8,4. 2 ± 0. 9,2. 7 ± 0. 6,and 3. 8 ± 1. 0,respectively in the control group;all P < 0. 01). There were no significant differences in naming,attention,abstract ability,orientation ability scores compared with the control group (all P > 0. 05). There were no significant differences in the MoCA total scores and each single test score of the patients between the left stenosis and the right stenosis groups (P > 0. 05). Conclusion The patients with asymptomatic unilateral severe ICAS have cognitive impairment generally;it is characterized by delay memory,visuospatial and executive functions,and language dysfunction.