血管内支架治疗对症状性颈内动脉狭窄患者临床疗效及认知功能的影响  

The effect of interventional treatment of intravascular stenting on clinical efficacy and cognitive function in patients with symptomatic internal carotid artery stenosis

作　　者：陈冬[1] 祁江峡[1] 梁晓 刘洋[1] CHEN Dong;QI Jiang-Xia;LIANG Xiao;LIU Yang(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《实用医院临床杂志》2020年第5期183-186,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析血管内支架治疗对症状性颈内动脉狭窄患者临床疗效及认知功能的影响。方法我院2015年8月至2018年8月收治的73例症状性颈内动脉狭窄患者,根据治疗方式分为对照组(35例)和观察组(38例),对照组予常规药物治疗,观察组予血管内支架治疗,对比两组治疗前后脑部血流变化超声情况,并对患者治疗后认知功能进行随访评估。结果观察组治疗后1月患侧血流平均通过时间(MTT)较治疗前缩短,局部脑血容量(rCBV)、局部脑血流量(rCBF)上升,变化程度大于对照组(P<0.05);两组收缩期峰值流速(PSV)及搏动指数均降低,且观察组下降程度大于对照组(P<0.05);对照组MTT、rCBV、rCBF较治疗前差异无统计学意义(P>0.05);观察组治疗后1年与治疗前比较,MoCA、MMSE评分及执行能力、信息处理速度、记忆力领域评分升高,且变化程度高于对照组(P<0.05),两组不良事件发生率差异无统计学意义(P>0.05)。结论血管内支架治疗相较于常规治疗临床疗效佳,可有效改善患者脑部血流变化,患者术后认知功能在短期内存在影响,一段时间后恢复至正常水平。Objective To analyze the effect of interventional treatment of intravascular stenting on clinical efficacy and cognitive function in patients with symptomatic internal carotid artery stenosis.Methods Seventy-three patients with symptomatic internal carotid artery stenosis admitted to our hospital from August 2015 to August 2018 were studied.They were divided into control group(n=35)and observation group(n=38)according to treatment methods.Patients in the control group were treated with conventional drugs,and the observation group was treated with interventional treatment of intravascular stenting.The status of cerebral blood flow in ultrasound before and after treatment was compared between the two groups,and the patients'cognitive function was followed up and evaluated after treatment.Results In the observation group,one month after treatment,MTT of the affected side was shorten while rCBV and rCBF were increased when compared with that before treatment,and the degree of changes was more than that of the control group(P<0.05).The PSV and pulsatility indexes of the two groups were decreased,and the degree of decline in the observation group was significantly more than that in the control group(P<0.05).There was no difference in MTT,rCBV,and rCBF of the control group before and after treatment(P>0.05).After one year of treatment,in the observation group,MoCA,MMSE scores and scores in the execution ability,information processing speed,and memory were significantly higher than those before treatment,and the changes were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Compared with conventional treatment,interventional treatment of intravascular stenting has better clinical effect.It can effectively improve the changes of cerebral blood flow in patients.Patients'cognitive function is affected in short term,and returns to the normal after a period of time.

关 键 词：症状性颈内动脉狭窄 脑缺血 介入治疗 支架 认知功能 

分 类 号：R654.3[医药卫生—外科学]