摘要
目的探讨无症状颈动脉狭窄(ACS)对认知功能的影响,分析P300潜伏期与认知障碍的相关性。方法前瞻性研究。纳入2018年10月—2020年1月蚌埠市第三人民医院神经内科120例ACS患者为狭窄组,选择年龄与之相匹配的同期正常体检者50例为对照组。对比两组受试者年龄、性别、受教育年限,吸烟史、饮酒史以及高血压、糖尿病、冠心病病史等临床基线资料;测定受试者P300潜伏期,应用蒙特利尔认知评估量表(MoCA)评估患者认知功能,比较两组MoCA评分、P300潜伏期、认知障碍人数,评估P300潜伏期与MoCA评分的相关性;按颈动脉内径缩小程度将ACS患者分为轻度狭窄组(缩小<30%,45例)、中度狭窄组(缩小30%~69%,40例)、重度狭窄组(缩小70%~99%,35例),进而比较3组患者认知障碍发生率。结果两组患者临床基线资料比较差异均无统计学意义(P值均>0.05)。狭窄组与对照组MoCA评分分别为(25.78±2.66)分和(27.64±1.35)分,P300潜伏期分别为(338.88±53.49)ms和(293.22±11.40)ms,两组比较差异均有统计学意义(t=-5.069、8.878,P值均<0.01)。符合认识障碍诊断标准者在对照组中占2%(1/50)、狭窄组中占25%(30/120),组间比较差异有统计学意义(χ^(2)=12.552,P<0.01)。随着颈内动脉狭窄程度的加重,MoCA评分降低、P300潜伏期延长、认知障碍人数增加,狭窄组与对照组比较,以及狭窄组内轻、中、重度狭窄程度亚组间比较,差异均有统计意义(P值均<0.05)。相关分析显示,P300潜伏期与MoCA评分呈负相关(r=-0.862,P<0.01)。结论ACS患者常存在认知障碍,且狭窄程度与认知障碍下降有关。P300潜伏期与认知障碍存在相关性,其在评估认知障碍方面的作用值得进一步研究。
Objective This study aims to investigate the effect of asymptomatic carotid artery stenosis(ACS)on cognitive function and analyze the correlation between P300 latency and cognitive impairment.Methods In this prospective study,120 patients with ACS admitted to the Department of Neurology of Bengbu Third People's Hospital from October 2018 to January 2020 were included in the stenosis group,and 50 patients that had normal physical examination results in the same period and matched their age were selected as the control group.The age,sex,education level,smoking history,alcohol consumption history,and number of patients with hypertension,diabetes,and coronary heart disease were compared between the two groups.The subjects'P300 latency was measured,and their cognitive function was evaluated with the Montreal cognitive assessment scale(MoCA).MoCA scores,P300 latency,and the number of cognitive impairments were compared between the two groups to evaluate the correlation between P300 latency and MoCA scores.The stenosis group was further divided into mild stenosis group(reduced<30%,45 cases),moderate stenosis group(reduced 30%-69%,40 cases),and severe stenosis group(reduced 70%-99%,35 cases)according to the narrowing degree of the diameter of the carotid artery,and the incidence of cognitive impairment was compared among the three groups.Results The clinical baseline data did not significantly differ between the two groups(all P values>0.05).The MoCA scores of the stenosis and control groups were(25.78±2.66)points,and(27.64±1.35)points,respectively.The incubation periods of P300 in the stenosis and control groups were(338.88±53.49)ms and(293.22±11.40)ms,respectively.The differences between the two groups were statistically significant(t=-5.069,8.878;all P values<0.01).The patients who met the diagnostic criteria of cognitive impairment accounted for 2%(1/50)in the control group and 25%(30/120)in the stenosis group,and these values significantly differed between the two groups(χ^(2)=12.552,P<0.01).With the aggravatio
作者
李敏
张干
苗青
Li Min;Zhang Gan;Miao Qing(Department of Neurology,the Third People's Hospital Affiliated to Bengbu Medical College,Bengbu 233000,China)
出处
《中华解剖与临床杂志》
2021年第2期204-208,共5页
Chinese Journal of Anatomy and Clinics
基金
蚌埠医学院自然科学研究计划(Byky16147)。
关键词
颈动脉狭窄
认知障碍
事件相关电位
Carotid stenosis
Cognitive impairment
Event-related potential
