无症状颈动脉狭窄患者认知功能障碍的临床特点分析  

Clinical characteristics of cognitive impairment in patients with asymptomatic carotid artery stenosis

作　　者：张华[1] 张淑平[1] 王小新[2] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,100029 [2]北京市密云县医院神经内科,101500

出　　处：《中国医药》2016年第11期1625-1629,共5页China Medicine

摘　　要：目的分析无症状颈动脉狭窄患者认知功能障碍的临床特点。方法选取2015年1—10月于首都医科大学附属北京安贞医院神经内科门诊就诊及住院的无症状颈动脉狭窄患者42例作为狭窄组，按北美有症状颈动脉内膜剥离术实验标准分为轻中度狭窄组（27例，狭窄30％-69％）和重度狭窄组（15例，狭窄70％～99％），另选取同期本院40例无颈动脉狭窄的患者作为对照组。采用简易智能状态量表（MMSE）评分、事件相关电位（ERP）-P300潜伏期和波幅检测，比较3组患者认知功能，并分析其与颈动脉狭窄程度的相关关系。结果轻中度和重度狭窄组患者的ERP—P300潜伏期长于对照组，差异均有统计学意义[（377±32）、（385±43）ms比（344±38）ms]（均P〈0．05）。重度狭窄组患者的MMSE评分低于对照组，差异有统计学意义[（25．6±1．7）分比（27．5±2．4）分]（P〈0．05）。相关性分析发现ERP—P300潜伏期与颈动脉狭窄程度呈正相关（F=2．237，P=0．032）。结论无症状颈动脉狭窄患者存在认知功能障碍；ERP—P300潜伏期延长对颈动脉狭窄患者的认知功能障碍的反应敏感，可以作为早期认知功能障碍的辅助检查。Objective To analysis clinical characteristics of cognitive impairment in patients with asymptomatic carotid artery stenosis. Methods Forty-two patients with asymptomatic carotid artery stenosis from January to October 2015 in Beijing Anzhen Hospital, Capital Medical University were enrolled as stenosis group, which was subdivided into mild-moderate stenosis group（30%-69% stenosis） and severe stenosis group （70%- 99% stenosis） according to the diagnostic standard of North American symptomatic carotid endarterectomy trial. Forty patients without carotid stenosis were selected as control group. Mini-mental state examination （MMSE） score, event related potentials（ERP）-P300 latency and amplitude were analyzed to evaluate the cognitive function. The correlation between cognitive function and carotid stenosis degree was analyzed. Results ERP-P300 latencies in mild-moderate and severe stenosis groups were significantly longer [ （ 377 ± 32 ）, （ 385 ± 43 ） ms vs （ 344 ± 38） ms] （P 〈0. 05） and the MMSE score in severe stenosis group was significant lower[ （25.6±1.7 ） socres vs （27. 5 ± 2.4 ） scores ] （ P 〈 0. 05 ） compared to those in control group. Correlation analysis showed positive correlation between ERP-P300 latency and carotid stenosis degree （F = 2. 237, P = 0. 032）. Conclusions Patients with carotid stenosis have cognitive impairment. Prolonged ERP-P300 latency is a sensitive diagnostic factor of cognitive impairment.

关 键 词：颈动脉狭窄 认知功能障碍 事件相关电位-P300 简易智能状态量表 

分 类 号：R543.4[医药卫生—心血管疾病]