轻型缺血性脑卒中患者数字减影脑血管造影术后注意网络功能的变化  

Changes in attention network function after digital subtraction angiography on patients with mild ischemic brain stroke

作　　者：王涛[1,2] 张梅[2] 余传庆[2] 宫琨[2] 武庆彬[2] 汪凯 WANG Tao;ZHANG Mei;YU Chuan-Qing(Department of Neurology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区：[1]安徽医科大学第一附属医院神经内科,安徽合肥230022 [2]淮南市第一人民医院神经内科

出　　处：《中国老年学杂志》2019年第21期5168-5173,共6页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(91432301,31571149)

摘　　要：目的研究轻型缺血性脑卒中患者数字减影脑血管造影术(DSA)后注意网络功能的变化特点。方法应用简易精神状态量表(MMSE)评估20位行DSA和15位未行DSA的脑卒中患者的基础认知功能。应用注意网络测试(ANT)评估两组患者警觉、定向、执行控制等三个注意网络成分效率,并比较上述两组患者术前和术后第5天的网络功能的变化特点。结果DSA组和非DSA组术前MMSE、焦虑抑郁得分无统计学差异(P>0.05),在注意网络功能方面警觉网络〔(27.95±32.19)vs(26.47±43.12)ms〕、定向网络〔(53.90±32.52)vs(52.67±26.31)ms〕和执行控制网络〔(157.20±94.68)vs(157.07±79.92)ms〕反应时无显著差异(P>0.05)。相比较术前,DSA组术后第5天的警觉网络反应时显著减少〔(27.95±32.19)vs(11.35±26.80)ms,P=0.010〕,非DSA组反应时显著增加〔(26.47±43.12)vs(39.60±38.67)ms,P=0.035〕;两组的定向和执行控制网络在两个时间点的差异无统计学意义(P>0.05)。用单因素协方差分析控制基础水平的差异后,DSA对两组警觉网络效率影响的差异有统计学意义。DSA组警觉网络效率的变化值与汉密尔顿焦虑评分变化值存在显著相关性(P<0.001)。结论DSA对轻型缺血性脑卒中患者注意网络功能有一定程度损害,主要体现在警觉网络效率,可能表现为患者不能及时灵敏地接受到外部信息刺激。Objective To explore the changes in attention network function after digital subtraction angiography (DSA) on patients with mild ischemic stroke. Methods Mini-Mental State Examination (MMSE) was used to assess the basic cognitive function of patients with brain stroke of 20 underwent DSA and 15 without DSA respectively,and Attention Network Test (ANT) paradigm was applied to assess the attention network efficiencies of alerting,orienting and executive control components,and the changes in the network function were compared between two groups at baseline and the 5th day after the surgery. Results There were no statistically significant differences in MMSE,anxiety and depression before the surgery between DSA surgery group and non-DSA surgery group ( P >0.05).And no significant differences existed between these two groups in alerting network〔(27.95±32.19) vs (26.47±43.12)ms〕,orienting network〔(53.90±32.52) vs (52.67±26.31)ms〕 and executive control network〔(157.20±94.68) vs (157.07± 79.92)ms〕.The reaction time of alerting network on the 5th day after surgery decreased significantly in DSA group compared with that before surgery 〔(27.95±32.19) vs (11.35±26.80)ms,P =0.010〕,while the reaction time increased significantly in non-DSA group patients (26.47±43.12 vs 39.60±38.67 ms,P =0.035),there was no statistical difference in orienting network and executive control network at these two time points between two groups ( P >0.05).With One-way ANCOVA controlling for the difference in baseline level,there was statistical difference in the effect caused by DSA surgery on the alerting network efficiency between the two groups.The changes of alerting network efficiency in DSA group was significantly related to the changes of Hamilton Anxiety Rating Scale ( P < 0.001). Conclusions DSA surgery causes some damage to the attention network function (mainly the alerting network efficiency) of patients with mild ischemic stroke,with the possible symptom that the patients cannot timely and sensitively receive

关 键 词：轻型缺血性脑卒中 注意网络功能 数字减影脑血管造影术 

分 类 号：R743.9[医药卫生—神经病学与精神病学]