頸動(dòng)脈狹窄與輕度認(rèn)知功能障礙關(guān)系探討
發(fā)布時(shí)間：2018-10-19 14:49
【摘要】：目的使用DSA或CTA對(duì)患者頸動(dòng)脈狹窄程度進(jìn)行分級(jí)診斷,探討頸動(dòng)脈狹窄分級(jí)及部位與患者輕度認(rèn)知功能障礙的關(guān)系。 方法采用簡(jiǎn)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(jīng)心理學(xué)量表對(duì)經(jīng)DSA或CTA證實(shí)的168例頸動(dòng)脈狹窄的患者(狹窄組)和79例頸動(dòng)脈無(wú)狹窄患者(對(duì)照組)進(jìn)行認(rèn)知功能評(píng)估。所有研究對(duì)象均由DSA或CTA對(duì)頸動(dòng)脈狹窄程度評(píng)估分級(jí)。按照北美癥狀性頸動(dòng)脈內(nèi)膜剝脫術(shù)試驗(yàn)協(xié)作組狹窄程度分級(jí)(NASCET分級(jí))：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(duì)神經(jīng)心理學(xué)測(cè)評(píng)得分和血管評(píng)估分級(jí)結(jié)果進(jìn)行相關(guān)性分析。 結(jié)果狹窄組患者綜合認(rèn)知測(cè)評(píng)得分較對(duì)照組得分低,結(jié)果存在統(tǒng)計(jì)學(xué)差異(p0.05)。其中,頸動(dòng)脈中度狹窄組、重度狹窄組患者綜合認(rèn)知測(cè)評(píng)得分與對(duì)照組相比顯著降低,差異有統(tǒng)計(jì)學(xué)意義(p0.05)；輕度狹窄組綜合認(rèn)知測(cè)評(píng)得分較對(duì)照組得分低,但差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)；中度頸動(dòng)脈狹窄組與輕度頸動(dòng)脈狹窄組、重度頸動(dòng)脈狹窄組與中度頸動(dòng)脈狹窄組比較,綜合認(rèn)知測(cè)評(píng)較上一級(jí)組得分低,差異有統(tǒng)計(jì)學(xué)意義(p0.05)；左側(cè)頸動(dòng)脈狹窄組患者的計(jì)算力、語(yǔ)言流暢性評(píng)分顯著低于對(duì)照組患者,右側(cè)頸動(dòng)脈狹窄組患者畫(huà)鐘及延遲回憶測(cè)驗(yàn)分?jǐn)?shù)均顯著低于對(duì)照組患者,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論 1.中-重度頸動(dòng)脈狹與輕度認(rèn)知功能障礙明顯相關(guān),隨頸動(dòng)脈狹窄程度增加,認(rèn)知功能損害加重。 2.左側(cè)頸動(dòng)脈中一重度狹窄患者以計(jì)算力、語(yǔ)言能力受損為顯著,右側(cè)頸動(dòng)脈中一重度狹窄患者以執(zhí)行功能、視空間結(jié)構(gòu)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(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R749.16
本文編號(hào)：2281460
[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(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R749.16
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 滿育平;馬隆佰;劉穎;梁千里;韓松苡;;非增強(qiáng)MRA和CTA在頸內(nèi)動(dòng)脈狹窄的臨床診斷價(jià)值[J];放射學(xué)實(shí)踐;2013年04期
，本文編號(hào)：2281460
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