CAJ | 학술논문

目的观察颈动脉内膜剥脱术对症状性颈动脉狭窄患者认知功能的影响. 方法选择自2013年2月至2014年8月在北京军区总医院附属八一脑科医院行颈动脉内膜剥脱术患者43例,分别于术前3d内和术后3个月采用蒙特利尔认知功能量表(MoCA)评价认知功能,CT脑灌注扫描评价脑血流情况,并将术前术后情况进行比较.同时根据术后MoCA评分改善情况,将患者分为明显改善组和无显著改善组,比较2组患者脑血流动力学指标手术前后变化情况. 结果 (1)患者术后3个月MoCA评分[(26.02±2.9)分]和相对脑血容量(1.00±0.08)较术前明显改善[(24.1±2.2)分、0.97±0.08],差异有统计学意义(P＜0.05).(2)MoCA评分改善明显患者中,术后相对脑血容量、相对脑血流量、相对平均通过时间3项参数值较术前均有显著改善,差异具有统计学意义(P＜0.05);而在MoCA评分无明显改善患者组中,此3项参数手术前后差异无统计学意义(P＞0.05). 结论颈动脉内膜剥脱术能改善症状性颈动脉狭窄患者的认知功能,这种改变可能与脑血流灌注改善有关.
목적 관찰경동맥내막박탈술대증상성경동맥협착환자인지공능적영향. 방법 선택자2013년2월지2014년8월재북경군구총의원부속팔일뇌과의원행경동맥내막박탈술환자43례,분별우술전3d내화술후3개월채용몽특리이인지공능량표(MoCA)평개인지공능,CT뇌관주소묘평개뇌혈류정황,병장술전술후정황진행비교.동시근거술후MoCA평분개선정황,장환자분위명현개선조화무현저개선조,비교2조환자뇌혈류동역학지표수술전후변화정황. 결과 (1)환자술후3개월MoCA평분[(26.02±2.9)분]화상대뇌혈용량(1.00±0.08)교술전명현개선[(24.1±2.2)분、0.97±0.08],차이유통계학의의(P＜0.05).(2)MoCA평분개선명현환자중,술후상대뇌혈용량、상대뇌혈류량、상대평균통과시간3항삼수치교술전균유현저개선,차이구유통계학의의(P＜0.05);이재MoCA평분무명현개선환자조중,차3항삼수수술전후차이무통계학의의(P＞0.05). 결론 경동맥내막박탈술능개선증상성경동맥협착환자적인지공능,저충개변가능여뇌혈류관주개선유관.
Objective To observe the influence of carotid endarterectomy in cognitive functions of patients with symptomatic carotid stenosis.Methods Forty-three patients admitted to our hospital and performed carotid endarterectomy from February 2013 to August 2014, were enrolled in the study.Cognitive functions of the patients were evaluated by Montreal cognitive function assessment (MoCA) and cerebral blood flow (CBF) by cerebral perfusion CT scan three days before and three months after operation, respectively.According to the MoCA scores after operation, the patients were divided into significant improvement group and non-significant improvement group, and their cerebral hemodynamics indexes were compared.Results (1) As compared with those before operation (24.1±2.2, 0.97±0.08), the MoCA scores (26.02±2.9) and relative cerebral blood volumes (rCBV, 1.00±0.08) three months after operation were significantly different (P＜0.05).(2) The postoperative relative CBF, rCBV and relative mean transmit time in the significant improvement group were significantly improved as compared with those preoperative indexes (P＜0.05);whereas, these values in the non-significant improvement group didn't show significant difference between preoperative and postoperative indexes(P＞0.05).Conclusion Carotid endarterectomy may help to improve the cognitive function in those patients with symtompatic carotid stenosis, and the effect might be associated with the improvement of cerebral perfusion.