颈动脉血管重建术对颈动脉狭窄患者认知功能的影响  

Effects of Carotid Revascularization on Cognitive Function in Patients with Carotid Stenosis

作　　者：滕乐群 沈晨阳 TENG Le-Qun;SHEN Chen-Yang(Vascular Surgery Center,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China;Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院阜外医院血管外科,北京100037 [2]中国医学科学院北京协和医学院

出　　处：《中国卒中杂志》2020年第10期1128-1133,共6页Chinese Journal of Stroke

摘　　要：颈动脉狭窄会导致患者远期认知功能下降,而既往研究表明颈动脉内膜剥脱术和支架置入术作为治疗颈动脉狭窄的主要术式,可以改善患者的认知功能,尤其是执行能力等特定领域的认知水平。进一步研究发现颈动脉血管重建术中栓子的形成,术后脑血流灌注提高,以及神经代谢水平等改变可能在机制上解释颈动脉重建术后认知功能的变化;此外,围术期炎症反应,血脂水平,以及基因易感性等都是术后远期认知功能结局的临床预测因素,以上因素对于提高颈动脉狭窄患者的生活质量、治疗术式的优化具有重要临床意义。Carotid stenosis can lead to long-term cognitive function decline.Carotid endarterectomy and carotid artery stenting,two major procedures for carotid stenosis,have been proven to improve the cognitive function,especially for executive domain.Further studies found that the formation of emboli during the operation,the increase of cerebral blood flow perfusion and the change of neurometabolism might account for the changes in cognitive function after carotid revascularization.In addition,perioperative inflammatory response,lipid level and gene susceptibility may be predictors of long-term cognitive prognosis,and all the above factors are of great clinical significance for improving the life quality of patients with carotid stenosis and optimizing the procedures.

关 键 词：颈动脉狭窄 颈动脉支架置入术 颈动脉内膜剥脱术 认知功能 

分 类 号：R651.12[医药卫生—外科学]