颈动脉支架植入与药物治疗对脑梗死合并认知功能障碍对比研究.docVIP

颈动脉支架植入与药物治疗对脑梗死合并认知功能障碍对比研究 　　[摘要] 目的 探究颈动脉支架植入术对脑梗死合并认知功能障碍患者支架植入后认知功能的影响。方法 选取有认知功能障碍的脑梗死患者80例，在常规治疗的基础上，将有适应证的45例患者行颈动脉支架血管成形术（支架组），未行支架治疗的35例患者给予药物治疗（药物组）。在治疗前及治疗后1、3、6个月应用简易精神状态检查量表（MMSE）、蒙特利尔认知功能量表（MoCA）、日常生活能力量表（Barthel指数）来观察认知功能的变化。结果 经治疗6个月的药物组和手术后1、3、6个月的支架组在MMSE、MoCA评分及Barthel指数明显提高，与治疗前相比有统计学意义（P0.05）；支架组MMSE、MoCA评分及Barthel指数较药物组相比亦有明显提高，两者相比有统计学意义（P0.05）。结论 颈动脉支架植入术可改善脑梗死合并认知功能障碍患者的认知功能障碍。 　　[关键词] 颈动脉支架置入；药物治疗；脑梗死认知功能障碍；对比研究 　　[中图分类号] R743.3 [文献标识码] A [文章编号] 2095-0616（2015）18-07-05 　　[Abstract] Objective To study the influence of cognitive impairment of underwent carotid stent implantation in patients with cerebral infarction combined cognitive impairment. Methods Of the 80 patients with cerebral infarction combined cognitive impairment， based on the routine treatment， 45 patients with indication in stent group were treated with underwent carotid stent transluminal angioplasty， and the other 35 patients in drug group were treated with drug therapy. To observe the changes of cognitive function by mini mental state examination （MMSE）， Montreal cognitive function scale（MoCA）， daily living measuring scale （Barthel index） before treatment and treatment after 1， 3， 6 months. Results The MMSE， MoCA score， and Barthel index in drug group after treatment 6 months and in stent group after operation 1， 3， 6 months were obviously increased compared with before treatment， the differences was statistically significant（P0.05）， and which in stent group was obviously increased compared with which in drug group， the differences was statistically significant（P0.05） . Conclusion Underwent carotid stent implantation could improve the cognitive impairment in patients with cerebral infarction combined cognitive impairment. 　　[Key words] Underwent carotid stent implantation； Drug therapy； Cerebral infarction combined cognitive impairment； Comparative study 　　认知功能涉及记忆、注意、感知、计算、执行功能、语言和思维理解等各个方面。大部分脑梗死患者会有一定程度的认知功能损害，1/3的血管性认知功能障碍可发展为痴呆，对社会功能及生活功能有直接的影响。脑梗死合并认知功能损害是当今神经精