[1]朱青峰,朱义霞,王 瑜,等.支架成形术对重度颈动脉狭窄病人脑灌注及认知功能的影响[J].中国临床神经外科杂志,2018,(10):652-654.[doi:10.13798/j.issn.1009-153X.2018.10.004]
　ZHU Qing-feng,ZHU Yi-xia,WANG Yu,et al.Effects of stent angioplasty on cerebral perfusion and cognitive function in patients with severe carotid artery stenosis[J].,2018,(10):652-654.[doi:10.13798/j.issn.1009-153X.2018.10.004]
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支架成形术对重度颈动脉狭窄病人脑灌注及认知功能的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年10期
页码:
652-654
栏目:
论著
出版日期:
2018-10-25

文章信息/Info

Title:
Effects of stent angioplasty on cerebral perfusion and cognitive function in patients with severe carotid artery stenosis
文章编号:
1009-153X（2018）10-0652-03
作者:
朱青峰; 朱义霞; 王 瑜; 王国芳
030001 太原，解放军第264医院神经外科（朱青峰、朱义霞、王 瑜、王国芳）
Author(s):
ZHU Qing-feng;  ZHU Yi-xia;  WANG Yu;  WANG Guo-fang.
Department of Neurosurgery, The 264th Hospital, PLA, Taiyuan 030001, China
关键词:
重度颈动脉狭窄; 血管成形术; 脑灌注; 认知障碍
Keywords:
Carotid artery stenosis;  Angioplasty;  Cerebral perfusion;  Cognitive function;  Stent
分类号:
R 743; R 815.2
DOI:
10.13798/j.issn.1009-153X.2018.10.004
文献标志码:
A
摘要:
目的 探讨重度颈动脉狭窄支架成形术后脑灌注和认知功能障碍的变化。方法 2014年1~12月行血管内支架成形术治疗重度（狭窄≥75%）颈动脉狭窄20例。术前5 d、术后3周采用320排螺旋CT评估脑灌注，用蒙特利尔国际认知评估量表（MoCA）评分评估认知功能。结果 重度颈动脉狭窄支架成形术后脑灌注指标脑血流量、脑血容量、平均通过时间、达峰时间较术前均明显改善（P<0.05）；重度颈动脉狭窄病人术后认知功能MoCA评分[（26.3±2.2）分较从术前5 d[（23.3±1.7）分]明显提高（P<0.05）。结论 重度颈动脉狭窄病人存在不同程度低灌注和认知功能障碍，支架成形术可以改善脑灌注，改善病人认知功能。
Abstract:
Objective To study the effects of stent angioplasty on cerebral perfusion and cognitive function in the patients with severe carotid artery stenosis (sCAS). Methods The stent angioplasty was performed in 20 patients with sCAS. The cerebral perfusion and cognitive function were assessed by the 320 row CT and the Chinese version of Montreal Cognitive Assessment Questionnaire CMOCA before and after the stent angioplasty in all the patients, respectively. Results The cerebral blood flow, cerebral blood volume, mean transit time and time to peak after the stent angioplasty of the carotid arteries were significantly improved compared with those before the stent angioplasty in these patients with sCAS (P<0.05). The MoCA scores of cognitive function [(26.3±2.2) points] were significantly higher after the angioplasty than those [(23.3±1.7) points] before the angioplasty in the patients with sCAS (P<0.05). Conclusion The stent angioplasty can significantly improve the cerebral perfusion, and cognitive function in the patients with sCAS.

参考文献/References:

[1] 胡子成，张莉莉，皮 燕，等. 颈动脉支架置入术对无症状 性颈动脉高度狭窄患者认知功能的影响[J]. 重庆医学， 2015，44（1）：34-35.
[2] Casas-Hernanz L, Garolera M, Badenes-Guia D, et al. The effect of carotid occlusion in cognition before endarterec- tomy [J]. Archives Clin Neuropsychol, 2012, 27(8): 879- 890.
[3] Cheng Y, Wang YJ, Yan JC, et al. Effects of carotid artery stenting oncognitive function in patients with mild cognitive impairement and carotid stenosis [J]. Exp Ther Med, 2013, 5 (4): 1019-1024.
[4] Sztriha LK, Neneth D, Sefcsik T, et al. Carotid stenosis and the cognitive function [J]. J Neurol Sci, 2009, 283(1/2): 36- 40.
[5] 张洪波，穆林蔚，孙彦辉，等. 脑肿瘤患者围手术期认知功 能障碍临床研究[J]. 中华神经外科杂志，2015，31（3）： 225-227.
[6] 聂淑敏，潘旭东，刘佩云. 经颅多普勒超声检测颈内动脉 重度狭窄或闭塞患者血流动力学的改变[J]. 中华临床医 师杂志：电子版，2011，5（6）：1737-1739.
[7] Ho CY, Hussain S, Alan T, et al. Accuracy of CT cerebral perfusion in predicting infarct in the emergency department: lesion characterization on CT perfusion based on commer- cially available software [J]. Emerg Radiol, 2013, 20(3): 203-212.
[8] Hoeffner EG, Case I, Jain R, et al. Cerebral perfusion CT: techniqueand clinical applications [J]. Radiology, 2004, 231 (3): 632-644.
[9] 简崇东，黄建敏，蒙兰青，等. 颅内外动脉支架植入术前后 脑灌注CT 成像的变化[J]. 中国老年学杂志，2014，34 （6）：3022-3023.
[10] 程留慧，王道清，刘 珂，等. 双源CT血管成像对头颈部 动脉支架置入后通畅情况分析[J]. 中华老年心脑血管病 杂志，2014，16（11）：1182-1184.
[11] 郭倩倩，周立春. 颈动脉狭窄患者脑血管储备的研究进展 [J]. 中华临床医师杂志：电子版，2013，7（4）：1732-1734.
[12] 范雁东，杜郭佳，枉永新，等. 儿童脑积水第三脑室底造瘘 术后脑认知功能的研究[J]. 中华神经外科杂志，2013，29 （3）：263-266.
[13] 于江龙，买尔阿笆，木塔力前，等. 颈动脉周围交感神经网 剥脱切除术对学龄前脑瘫患儿头部血供及认知情况的 影响[J]. 中华神经外科杂志，2015，31（3）：277-280.
[14] Li J, Wang YJ, Zhang M, et al. Vascular risk factors promote conversion from mild cognitive impairment to Alzheimer disease [J]. Neurology, 2011, 76(17): 1485-1491.
[15] Silvestrini M, Viticchi G, Falsetti L, et al. The role of carotid atherosclerosis in Alzheimer’s disease progression [J]. Alzheimers Dis, 2011, 25(4): 719-726.
[16] Ghogawala Z, Westerveld M, Aminhanjani S. Cognitive out- comes after carotid revascularization: the role of cerebral emboli and hypoperfusion [J]. Neurosurgery, 2008, 62: 385- 395.
[17] Grunwald IQ, Papanagiotou PR, Reith W, et al. Influence of carotid stenting on cognitive function [J]. Neuroradiology, 2010, 52(1): 61-66.
[18] 石向群，张志强，张 亮，等. 无症状性颈内动脉中重度狭 窄及支架置入对患者认知功能的影响[J]. 中国脑血管病 杂志，2014，11（12）：630-633.
[19] 向 静，张 涛，周华东. 老年颈动脉狭窄与认知功能障 碍的相关研究[J]. 中华临床医师杂志：电子版，2011，5 （6）：1575-1578.
[20] Mendiz OA, Sposato LA, Fabbro N, et al. Improvement in executive function after unilateral carotid artery stenting for severe asymptomatic stenosis [J]. J Neurosurg, 2012, 116 (1): 179-184.
[21] Watanabe J, Ogata T, Hamada O, et al. Improvement of cog nitive function after carotid endarterectomy-a new strategy for the evaluation of cognitive function [J]. J Stroke Cere- brovasc Dis, 2014, 23( 6): 1332-1336.

备注/Memo

备注/Memo:
基金项目：山西省科技攻关课题（20120313018-2）
通讯作者：王国芳，E-mail：wangguofangvip@163.com
更新日期/Last Update: 2018-09-30