急性心肌梗死患者PCI与认知功能的关联性研究  

The relationship between PCI and cognitive impairment in AMI patients

作　　者：施莹[1] 刘海润[2] 杨子聪[1] 薛焱[1] 卢建勇 黄信顺 曾涛[1] 刘伶[1] SHI Ying;LIU Hai-run;YANG Zi-cong(Department of Cardiology,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院心内科,南宁530021 [2]广西壮族自治区人民医院认知睡眠中心,南宁530021

出　　处：《中国临床新医学》2019年第5期478-483,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：国家自然科学基金项目(编号:81460061);广西医疗卫生适宜技术研究与开发项目(编号:S201546);广西卫健委科研课题(编号:Z2014213)

摘　　要：目的探讨急性心肌梗死(acute myocardial infarction,AMI)患者经皮冠状动脉腔内支架植入术(percutaneous coronary artery intervention,PCI)与认知功能的关联性。方法该研究共纳入155例AMI患者,99例诊断AMI后行PCI治疗为PCI组,56例未行PCI治疗为对照组,所有对象入院后均使用认知功能电话问卷-修订版(Telephone Interview for Cognitive Status-Modified,TICS-m)进行认知功能评估,相关生化指标均由广西壮族自治区人民医院检验科按标准流程进行检测。所有研究对象随访1年后再次进行认知功能评估。结果两组间基线TICS-m评分各项差异均无统计学意义(P> 0.05),随访1年后再次进行认知功能评估,重复测量方差分析结果提示随着时间延长,对照组认知功能总分显著低于PCI组[(31.07±1.74)分vs (32.56±2.21)分,P=0.000],其中对照组语言和注意力评分显著低于PCI组[(13.16±1.43)分vs (14.49±1.64)分,P=0.000],但两组间记忆力及定向力评分差异无统计学意义(P> 0.05)。对不同部位的AMI患者认知功能评分进行分析发现,无论对照组还是PCI组,均未发现不同部位AMI患者随着时间延长认知功能损伤存在统计学差异(P> 0.05)。结论行PCI手术治疗的AMI患者远期认知功能损伤较未行PCI手术治疗者轻。Objective To investigate the relationship between percutaneous coronary artery intervention(PCI) and cognitive impairment in acute myocardial infarction(AMI) patients. Methods One hundred and fifty-five AMI patients were enrolled in this study, of whom 99 AMI cases were performed PCI(PCI group) and 56 AMI cases were not performed PCI(control group). Their cognitive function was evaluated by Telephone Interview for Cognitive Status-Modified(TICS-m), and biochemistry indexes were tested by standard procedures in the Lab of the People′s Hospital of Guangxi Zhuang Autonomous Region. All the subjects were followed up for 1 year, and their cognitive function was re-evaluated by TICS-m at the end of the follow-up. Results There was no significant difference in TICS-m between the PCI group and the control group at baseline ( P >0.05). The results indicated that the total scores of TICS-m in the control group were significantly lower than those in the PCI group[(31.07±1.74)points vs (32.56±2.21)points, P =0.000], among which verbal and attention function scores in the control group were significantly lower than those in the PCI group[(13.16±1.43)points vs (14.49±1.64)points, P =0.000], while there were no significant differences in memory and orientation scores( P >0.05) after 1-year follow up. As time went on, there were no significant differences in cognitive impairemnts among the patients with AMI in different positions in both of the two groups( P >0.05). Conclusion The AMI patients not treated with PCI have more severe long-term cognitive impairment than those treated with PCI.

关 键 词：急性心肌梗死 经皮冠状动脉腔内支架植入术(PCI) 认知功能损伤 

分 类 号：R542.22[医药卫生—心血管疾病]