颈内动脉重度狭窄或闭塞患者侧支循环代偿对认知功能的影响  

Effects of compensatory collateral circulation on cognitive function in the patients with severe stenosis or occlusion of internal carotid

作　　者：李文臣 徐子奇[2] 

机构地区：[1]浙江省东阳市人民医院神经内科,浙江东阳322100 [2]浙江大学医学院附属第一医院神经内科,浙江杭州310003

出　　处：《中国现代医生》2016年第16期17-20,共4页China Modern Doctor

基　　金：浙江省医药卫生一般研究计划(2015KYA080)

摘　　要：目的探讨颈内动脉重度狭窄或闭塞患者侧支循环代偿对认知功能的影响。方法选择2014年1月~2015年12月在我院治疗的颈内动脉重度狭窄或者闭塞的发生缺血性脑血管疾病的患者68例的临床资料进行回顾性分析。采用DSA、MRA检查或者CTA检查患者侧支循环代偿情况，根据患者MRA检查或者CTA检查结果交通支开放情况分为前交通开放组、前交通未开放组，后交通支开放组及后交通支为开放组。根据患者DSA检查结果初级侧支开放组、次级侧支开放组和未开放组。分析前交通支开放、后交通支开放、初级侧支开放及次级侧支开放对患者认知功能的影响。结果前交通支开放患者MoCA评分显著高于未开放患者（P〈0．01）；前交通开放患者在视空、执行能力、注意与计算、抽象方面对患者认知功能的影响较大，差异有高度统计学意义（P〈0．01）。后交通动脉开放与未开放患者MMSE、MoCA评分比较差异无统计学意义（P〉0．05）。初级侧支开放与次级侧支开放与未开放患者MMSE、MoCA评分比较无显著差异（P〉0．05），认知功能各维度得分差异无统计学意义（P〉0．05）。结论颈内动脉闭塞或者重度狭窄的前循环动脉开放能够改善患者的认知功能。Objective To explore the effects of compensatory collateral circulation on cognitive function in the patients with severe stenosis or occlusion of internal carotid. Methods Clinical data of 68 patients with isehemic eerebrovaseu- lar diseases induced by severe stenosis or occlusion of internal carotid who were treated in our hospital from January 2014 to December 2015 were selected and retrospectively analyzed. DSA, MRA examinations or CTA examination were applied to test the compensatory condition of collateral circulation in the patients. According to the opening of commu- nicating artery from the results of MRA or CTA examination, the patients were divided into the opening of anterior communicating artery group, non-opening of anterior communicating artery group, opening of posterior communicating artery group, and non-opening of posterior communicating artery group. According to the DSA examination results, the patients were divided into the primary collateral opening group, secondary collateral opening group and non-opening group. The effects of opening of anterior communicating artery, opening of posterior communicating artery, primary col- lateral opening and secondary collateral opening on patients＂ cognitive function were analyzed. Results MoCA score in the opening of anterior communicating artery group was significantly higher than that in the non-opening group （P〈 0.01）; the effects of the opening of anterior communicating artery on patients＂ cognitive functions were more significant in terms of visual-space, executive capacity, attention and calculation, and abstraction, and the differences were statis- tically significant （P〈0.01）. MMSE and MoCA scores compared between the opening of posterior communicating artery group and non-opening group were not significantly different （P〉0.05）. MMSE and MoCA scores compared between the primary collateral opening group and the secondary collateral opening group and the non-opening group were not sig- nificantly different（P〉0.05）. The

关 键 词：颈内动脉 狭窄 闭塞 侧支循环代偿 认知功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]