左右颅内动脉重度狭窄或闭塞患者认知功能损害研究

目的研究左、右颅内动脉重度狭窄或闭塞对患者认知功能的影响,旨在早期发现患者认知功能损害,从而及时采取有效干预措施。方法选择2013年9月~2016年5月期间中国人民解放军火箭军特色医学中心“脑卒中医疗救治研究中心”门诊和住院患者。其中,正常组53例,左侧颅内动脉重度狭窄或者闭塞患者15例,右侧颅内动脉重度狭窄或者闭塞患者13例。对所有患者进行血管狭窄程度评估、根据3T-MRI FLAIR序列的左、右ASPECTS和pc-ASPECTS评分筛选均为10分患者,应用传统的MMSE、MoCA量表和多维心理评估系统对患者进行神经心理评估。结果左侧颅内动脉重度狭窄或闭塞患者MMSE、时间定向力、记忆评分均显著低于正常组(P<0.01,P<0.05,P<0.01);左、右侧颅内动脉重度窄或闭塞患者词语辨析测验评分均显著低于正常组(P<0.05)。结论颅内动脉重度狭窄或闭塞与认知功能损害相关,左侧较右侧颅内动脉重度狭窄或闭塞可能更易导致认知功能损害。因此,对颅内动脉重度狭窄或闭塞患者进行针对性早期干预和治疗具有重要意义。

Study of cognitive impairment in patients with severe stenosis or occlusion of left and right intracranial arteries

Objective Aim to detect the cognitive function impairment early,we studied the effects of severe stenosis or occlusion of left and right intracranial artery,so as to take effective intervention measures in a timely manner.Methods All patients were chosen from the outpatients and inpatients New Era Stroke Care and Research Institute of PLA Rocket Force Characteristic Medical Center from September 2013 to May 2016,a total number of 242.There were 53 patients in the normal group,15 and 13 patients in left and right intracranial artery severe stenosis or occlusion groups respectively.All patients were assessed for vascular stenosis,screened for 10 points according to the left/right ASPECTS and pc-ASPECTS scores based on 3T-MRI FLAIR sequence,and neuropsychological assessment was performed using the traditional MMSE,MoCA scale and multidimensional psychological assessment system.Results The scores of MMSE,time orientation and memory of patients with severe stenosis or occlusion of the left intracranial artery were significantly lower than those of normal group(P<0.01,P<0.05,P<0.01);the scores of word discrimination test were significantly lower in patients with left and right intracranial artery severe stenosis or occlusion than that of normal group(P<0.05).Conclusion Cognitive impairment was associated with severe intracranial artery stenosis or occlusion.Severe intracranial artery stenosis or occlusion of the left may be more likely to cause cognitive impairment than the right side.Therefore,it is of great significance to carry out targeted early intervention and treatment for patients with severe intracranial arterial stenosis or occlusion.