颅内血管狭窄患者介入治疗术后发生认知功能障碍的危险因素分析  

Risk factors for postoperative mild cognitive impairment in patients with intracranial vascular stenosis undergoing interventional therapy

作　　者：赵红艳 郑文权 刘海涛 Zhao Hongyan;Zheng Wenquan;Liu Haitao(Department of Neurology,Pingdingshan Coal Mine Shenma Group General Hospital,Pingdingshan 467000,China)

机构地区：[1]平煤神马集团总医院神经内科,平顶山467000

出　　处：《中国实用医刊》2022年第16期41-45,共5页Chinese Journal of Practical Medicine

摘　　要：目的分析颅内血管狭窄患者介入治疗术后发生认知功能障碍(MCI)的危险因素。方法抽取156例于平煤神马集团总医院行颅内血管狭窄介入治疗的患者资料,统计术后MCI的发生情况并分组(MCI组及非MCI组),比较两组患者的基线资料,分析术后发生MCI的独立危险因素。结果颅内血管狭窄患者156例中术后并发认知障碍48例(30.77%,48/156),术后未并发认知障碍108例(69.23%,108/156)。比较MCI组与非MCI组患者基线资料,结果显示,年龄、高血压、收缩压、血管狭窄程度、病变血管数≥2支、蒙特利尔认知评估量表评分、简易精神状态检查量表评分、血清内皮细胞微颗粒(EMP)水平、血浆可溶性白细胞分化抗原40配体(sCD40L)和血小板反应蛋白-1(TSP-1)水平是影响颅内血管狭窄患者介入治疗术后发生MCI的单因素。多因素Logistics回归分析结果显示,年龄、高血压、血管狭窄程度(>50%)、病变血管数(≥2支)、术前血浆sCD40L和TSP-1及血清EMP水平是颅内血管狭窄介入治疗术后发生MCI的独立危险因素(P<0.05)。受试者工作特征曲线分析结果显示,血浆sCD40L、TSP-1及血清EMP水平单项及联合诊断对介入治疗术后发生MCI诊断效能较高,且联合诊断价值最高。结论年龄、高血压、血管狭窄程度(>50%)、病变血管数(≥2支)、术前血浆sCD40L和TSP-1及血清EMP水平均是影响颅内血管狭窄介入治疗术后发生MCI的独立危险因素,其中血浆sCD40L、TSP-1及血清EMP水平对颅内血管狭窄患者介入治疗术后发生MCI具有较高的诊断价值。Objective To analyze the risk factors for postoperative mild cognitive impairment(MCI)in patients with intracranial vascular stenosis undergoing interventional therapy.Methods The data of 156 patients who underwent interventional therapy for intracranial vascular stenosis in Pingdingshan Coal Mine Shenma Group General Hospital were selected,and their postoperative MCI occurrence was counted,and the patients were divided into groups(MCI group and non-MCI group).The baseline data of patients in the two groups were compared,and the independent risk factors for postoperative MCI were analyzed.Results Among the 156 patients with intracranial vascular stenosis,48 cases(30.77%,48/156)had postoperative cognitive impairment,and 108 cases(69.23%,108/156)had no postoperative cognitive impairment.The baseline data of patients in the MCI group and the non-MCI group were compared.The results showed that age,hypertension,systolic blood pressure,degree of vascular stenosis,the number of diseased blood vessels≥2,the Montreal Cognitive Assessment score,and the Mini-Mental State Examination score,the plasma levels of soluble leukocyte differentiation antigen 40 ligand(sCD40L),thrombospondin-1(TSP-1)and serum endothelial microparticles(EMP)levels were the single factors that affected the occurrence of MCI in patients with intracranial vascular stenosis after interventional therapy.The results of multivariate Logistic regression analysis showed that age,hypertension,degree of vascular stenosis(>50%),diseased blood vessels(≥2 vessels),preoperative plasma sCD40L plasma TSP-1,and serum EMP levels were independent risk factors for MCI after intracranial vascular stenosis intervention(P<0.05).Receiver operating characteristic curve analysis showed that the single and combined diagnosis of plasma sCD40L,plasma TSP-1 and serum EMP levels had higher diagnostic efficacy for MCI after interventional therapy,and the combined diagnostic value was the highest.Conclusions Age,hypertension,degree of vascular stenosis(>50%),diseased blood vessel

关 键 词：颅内血管狭窄 介入治疗 认知功能障碍 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]