【摘要】：目的使用DSA或CTA對患者頸動脈狹窄程度進行分級診斷,探討頸動脈狹窄分級及部位與患者輕度認知功能障礙的關系。 方法采用簡易智能精神狀態(tài)量表(MMSE)、蒙特利爾量表(MoCA)、臨床癡呆量表(CDR)、日常生活能力量表(ADL)、漢密爾頓抑郁量表(HAMD)及漢密爾頓焦慮量表(HAMA)等神經心理學量表對經DSA或CTA證實的168例頸動脈狹窄的患者(狹窄組)和79例頸動脈無狹窄患者(對照組)進行認知功能評估。所有研究對象均由DSA或CTA對頸動脈狹窄程度評估分級。按照北美癥狀性頸動脈內膜剝脫術試驗協(xié)作組狹窄程度分級(NASCET分級)：輕度狹窄(狹窄率30%)、中度狹窄(狹窄率30%-69%),重度狹窄(狹窄率70%-100%),對神經心理學測評得分和血管評估分級結果進行相關性分析。 結果狹窄組患者綜合認知測評得分較對照組得分低,結果存在統(tǒng)計學差異(p0.05)。其中,頸動脈中度狹窄組、重度狹窄組患者綜合認知測評得分與對照組相比顯著降低,差異有統(tǒng)計學意義(p0.05)；輕度狹窄組綜合認知測評得分較對照組得分低,但差異無統(tǒng)計學意義(p0.05)；中度頸動脈狹窄組與輕度頸動脈狹窄組、重度頸動脈狹窄組與中度頸動脈狹窄組比較,綜合認知測評較上一級組得分低,差異有統(tǒng)計學意義(p0.05)；左側頸動脈狹窄組患者的計算力、語言流暢性評分顯著低于對照組患者,右側頸動脈狹窄組患者畫鐘及延遲回憶測驗分數(shù)均顯著低于對照組患者,差異有統(tǒng)計學意義(P0.05)。 結論 1.中-重度頸動脈狹與輕度認知功能障礙明顯相關,隨頸動脈狹窄程度增加,認知功能損害加重。 2.左側頸動脈中一重度狹窄患者以計算力、語言能力受損為顯著,右側頸動脈中一重度狹窄患者以執(zhí)行功能、視空間結構及延遲回憶受損為顯著。
[Abstract]:Objective to investigate the relationship between carotid stenosis and mild cognitive impairment (MCI) in patients with carotid artery stenosis by using DSA or CTA. Methods (MMSE), Montreal scale, (MoCA), clinical dementia scale, (CDR), activity of daily living scale, (ADL), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the changes of neuropsychological scale, such as DSA or CTA, by using simple mental state scale (MMSE), Montreal scale (MoCA), scale), and clinical dementia scale (CDR), scale). Cognitive function was evaluated in 168 patients with carotid artery stenosis (stenosis group) and 79 patients without carotid artery stenosis (control group). All subjects were graded by DSA or CTA for carotid artery stenosis. According to the NASCET classification of the North American symptomatic carotid endarterectomy test group, mild stenosis (30%), moderate stenosis (30 -69%), severe stenosis (70 -100%), neuropsychological assessment and blood use were performed on the basis of the classification of stenosis (30%), moderate stenosis (30% -69%) and severe stenosis (70% -100%). The correlation analysis of the grading results was carried out. Results the scores of comprehensive cognitive assessment in patients with stenosis were lower than those in control group (p0.05). The scores of comprehensive cognitive assessment in patients with moderate carotid artery stenosis and severe stenosis were significantly lower than those in control group (p0.05), and the scores of comprehensive cognitive assessment in mild stenosis group were lower than those in control group. But there was no significant difference (p0.05), the scores of comprehensive cognitive test in moderate carotid artery stenosis group and mild carotid artery stenosis group, severe carotid artery stenosis group and moderate carotid artery stenosis group were lower than those in the upper class group (p0.05). The score of computational power and language fluency in the left carotid artery stenosis group was significantly lower than that in the control group, and the score of clock drawing and delayed recall test in the right carotid artery stenosis group was significantly lower than that in the control group (P0.05). Conclusion 1. Moderate to severe carotid stenosis was significantly associated with mild cognitive impairment, and cognitive impairment increased with the increase of carotid stenosis. 2. In the patients with moderate to severe stenosis of left carotid artery, the ability of calculation and speech were significantly impaired, while the patients with moderate to severe stenosis of right carotid artery were impaired by executive function, visual spatial structure and delayed recall.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R749.16

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