摘要
目的探究大脑中动脉狭窄血管内治疗前后认知功能的变化及其可能机制。方法选取大脑中动脉狭窄患者22例为研究对象,根据是否接受血管内治疗分为治疗组和对照组。所有受试对象于术前、术后3 d和术后3月进行评估,比较两组认知功能变化差异。采用简易智能状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、剑桥老年认知检查量表中文版(CAMCOG-C)、语言流畅性测试、韦氏视觉复制、数字广度测试以及汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)等神经心理学量表评估患者认知功能及情绪;采用CT血管成像(CTA)、CT灌注成像(CTP)、数字减影血管造影(DSA)等影像学检查评估血管狭窄、脑灌注和侧支循环情况。结果在治疗组中,与术前和术后相比,术后3月随访期患者MoCA中延时回忆及韦氏视觉复制C1均有改善(P<0.05),且随访期得分高于对照组;MoCA子项抽象比较显示术前治疗组和对照组无显著差异,而随访期治疗组抽象评分高于对照组(P<0.05);在数字广度顺记中,治疗组术后和随访期较术前均有改善,差异有统计学意义(P<0.05)。多时相CTA(mCTA)和DSA均显示治疗组患者术后侧支循环明显改善,且相比较于术前,术后治疗组患者脑灌注显著增加,平均通过时间(MTT)减少(P<0.05)。结论大脑中动脉狭窄血管内治疗可能通过改善侧支循环,增加血液灌注改善患者的认知功能。
Objective To explore the changes of cognitive function before and after endovascular treatment of middle cerebral artery stenosis and its possible mechanism.Methods Twenty-two patients with middle cerebral artery stenosis were grouped into the treatment group and control group according to whether they received endovascular treatment or not.All subjects were evaluated at 3 d before operation,3 d after operation and 3 months after operation.The changes of cognitive function between the two groups were compared.The cognitive function and emotion of patients were evaluated by Mini Mental State scale(MMSE),Montreal Cognitive Assessment scale(MoCA),Cambridge Geriatric Cognitive examination scale(CAMCOG-C),language fluency test,Wechsler visual replica-tion,digit span test and neuropsychological scales,such as Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD).Vascular stenosis,cerebral perfusion and collateral circulation were evaluated by CT angiography(CTA),CT perfusion imaging(CTP)and digital subtraction angiography(DSA).Results In the treatment group,the delayed memory in MoCA and the C1 of Wechsler visual replication were significantly improved during the 3-month follow-up period,and the score during the follow-up period was higher than that in the control group.While there was no significant difference in the abstract comparison of MoCA subitems between the treatment group and the control group,the abstract score in the treatment group was significantly higher than that in the control group during the follow-up period.The digital span sequence score of treatment group were significantly improved at 3 days after operation and 3-month follow up compared to that before operation.The collateral circulation in the treatment group measured by Multiphase(mCTA)and DSA was significantly improved after operation.In addition,the cerebral perfusion in the treatment group was significantly increased after operation,and the average transit time(MTT)was significantly decreased(P<0.05).Conclusion Endovascular treatm
作者
余先锋
杨卫民
周霞
尹文文
余翔
孙中武
Yu Xianfeng;Yang Weimin;Zhou Xia(Dept of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022)
出处
《安徽医科大学学报》
CAS
北大核心
2021年第8期1285-1291,共7页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81771154)
安徽省自然科学基金(编号:1908085QH322)。
关键词
大脑中动脉
认知功能
支架置入术
CT血管造影
CT灌注成像
middle cerebral artery
cognitive function
stent implantation
CT angiography
CT perfusion imaging
