无症状性中重度颈内动脉狭窄患者认知功能障碍的临床研究  

Correlation between asymptomatic moderate and severe carotid stenosis and cognitive impairment

作　　者：黄晓东[1,2] 罗伟良[2] 梁素琴[2] 何艳[2] HUANG Xiao-dong;LUO Wei-liang;LIANG Su-qin(Shantou University Medical college,Shantou 515000,China;不详)

机构地区：[1]汕头大学医学院,广东汕头515000 [2]惠州市中心人民医院神经内科,广东惠州516001

出　　处：《中国处方药》2022年第4期184-186,共3页Journal of China Prescription Drug

基　　金：惠州市科技计划项目(2020Y095)。

摘　　要：目的研究无症状性中重度颈内动脉狭窄患者是否存在认知功能障碍。方法40例无症状性中重度颈内动脉狭窄患者作为研究组,同时期经检查确认无颈内动脉狭窄40例作为对照组,均使用简易智能状态检查量表(mini-mental state examination,MMSE)和蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)进行认知功能评估,同时收集高血压病、糖尿病、吸烟史及低密度脂蛋白、血肌酐、谷丙转氨酶等基线资料。结果与对照组比较,研究组有高血压、2型糖尿病、吸烟病史的比例及低密度脂蛋白水平较高(P<0.05)。研究组的MMSE评分较对照组低[(25.65±3.74)分vs.(28.88±1.24)分,P=0.001];MoCA评分较对照组明显降低[(23.30±4.39)分vs.(27.45±2.21)分,P=0.001];依据MoCA以及MMSE评分,研究组的认知功能障碍的检出率分别为65%和50%,明显高于对照组的17.5%和2.5%,两组差异有统计学意义(P<0.05);无论是研究组还是对照组,MoCA评分和MMSE评分对认知功能障碍的检出率比较均无明显差异(P>0.05)。结论无症状性中重度颈内动脉狭窄存在认知功能障碍,MoCA和MMSE两种评分对认知功能障碍的检出率并无明显差异。而高血压病、2型糖尿病、吸烟史及低密度脂蛋白胆固醇升高是无症状性颈内动脉狭窄的危险因素。Objective To study the correlation between asymptomatic moderate and severe internal carotid artery stenosis and cognitive impairment.Methods 40 patients with asymptomatic moderate and severe internal carotid artery stenosis were chosen as the objects of the study group,and 40 patients without internal carotid artery stenosis confirmed by examination were the objects of the control group.MMSE and MOCA were used to evaluate cognitive impairment,and the relevant clinical data of patients were collected at the same time.It includes hypertension,diabetes,smoking history and low density lipoprotein,blood creatinine,alanine aminotransferase,etc.Results Compared with the control group,the study group had a higher proportion of hypertension,type 2 diabetes,smoking history and lever of low density lipoprotein cholesterol(LDL-C)(P<0.05).The MMSE score of the study group was lower than that of the control group[(25.65±3.74)vs.(28.88±1.24),P=0.001].Meanwhile,the MOCA score of the study group was significantly lower than that of the control group[(23.30±4.39)vs.(27.45±2.21),P=0.001];According to MOCA and MMSE scores,the detection rates of cognitive impairment in the study group were 65%and 50%,which were significantly higher than 17.5%and 2.5%in the control group(P<0.05);Both in the study group and the control group,the detection rate of cognitive impairment by MOCA or MMSE scale was no significant difference.Conclusion Asymptomatic moderate and severe internal carotid artery stenosis is associated with cognitive impairment.There was no significant difference on the sensitive to cognitive impairment between MOCA scale and MMSE scale.Hypertension,type 2 diabetes,cigarette smoking and elevated LDL-C are associated risk factors for asymptomatic internal carotid artery stenosis.

关 键 词：颈内动脉狭窄 认知功能障碍 简易智能状态检查量表 蒙特利尔认知评估量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]