本文選題：頸動脈狹窄 + 認知功能　； 參考：《浙江大學》2014年碩士論文

【摘要】：目的： 進一步驗證癥狀性粥樣硬化性頸內(nèi)動脈狹窄支架植入術(shù)對認知功能的影響,探討手術(shù)前后腦灌注狀態(tài)與認知功能改變之間的關(guān)系。 方法： 采用多種認知評估量表(簡明精神狀態(tài)量表、手指敲擊試驗、連線試驗、韋氏成人記憶量表)對21例單側(cè)癥狀性粥樣硬化性頸內(nèi)動脈狹窄患者支架植入術(shù)前、術(shù)后6個月認知功能進行評估。同時采用CT全腦灌注掃描評價支架植入術(shù)前、術(shù)后患者腦灌注狀態(tài)。 結(jié)果： 21例患者均成功植入自膨式頸動脈支架。與支架植入術(shù)前相比,21例患者術(shù)后6個月總體認知功能水平(MMSE得分)無顯著性改變,但執(zhí)行功能(手指敲擊試驗得分)、注意力(連線試驗得分)以及記憶力(韋氏成人記憶量表得分)均顯著改善,差異具有統(tǒng)計學意義。根據(jù)全腦CT灌注掃描結(jié)果將患者分為低灌注組與非低灌注組。與非低灌注組患者相比,低灌注組患者術(shù)前總體認知功能水平(MMSE得分)、執(zhí)行功能(手指敲擊試驗得分)明顯較差,差異具有統(tǒng)計學意義。支架植入術(shù)后低灌注組患者總體認知功能水平(MMSE得分)無顯著性改變,而執(zhí)行功能(手指敲擊試驗得分)、注意力(連線試驗得分)以及記憶力(韋氏成人記憶量表得分)均有顯著性提高。非低灌注組患者術(shù)后各項認知功能均無顯著性改變。 結(jié)論： 粥樣硬化性頸內(nèi)動脈狹窄可導致大腦低灌注,從而引起認知功能障礙。頸動脈支架植入術(shù)可以有效改善伴有大腦低灌注的粥樣硬化性頸內(nèi)動脈狹窄引起的認知功能損害。
[Abstract]:Aim: to investigate the effect of stent implantation on cognitive function in patients with symptomatic atherosclerotic internal carotid artery stenosis and to explore the relationship between cerebral perfusion status and cognitive function before and after operation. Methods: 21 patients with unilateral symptomatic internal carotid artery stenosis were treated with multiple cognitive assessment scales (brief mental state scale, finger tapping test, wired test, Wechsler adult memory scale) before stenting. Cognitive function was evaluated 6 months after operation. At the same time, CT whole brain perfusion scan was used to evaluate the cerebral perfusion status before and after stent implantation. Results: self-expandable carotid stents were successfully implanted in 21 patients. There was no significant change in total cognitive function (MMSE) in 21 patients 6 months after operation compared with that before stent implantation. However, the executive function (finger tapping test score), attention (wired test score) and memory (Wechsler adult memory scale score) were significantly improved, the difference was statistically significant. Patients were divided into low perfusion group and non-hypoperfusion group according to CT perfusion scan results. Compared with the non-hypoperfusion group, the total cognitive function (MMSE) and the executive function (the finger tapping test score) of the low perfusion group were significantly lower than those of the non-hypoperfusion group, and the difference was statistically significant. There was no significant change in the overall cognitive function (MMSE score) after stent implantation in the low perfusion group. The scores of executive function (finger tapping test), attention (wired test) and memory (Wechsler adult memory scale) were significantly improved. There were no significant changes in cognitive function after operation in non-hypoperfusion group. Conclusion: atherosclerotic internal carotid artery stenosis may lead to cerebral hypoperfusion and cognitive impairment. Carotid stent implantation can effectively improve cognitive impairment caused by atherosclerotic internal carotid artery stenosis with cerebral hypoperfusion.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.3

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