颈内动脉狭窄对脑卒中患者脑白质病变及认知水平影响的研究

Effect of internal carotid artery stenosis on cerebral white matter lesions and cognition in stroke patients

摘要:

目的 探讨颈内动脉狭窄对脑卒中患者脑白质病变及认知水平的影响。方法 选取2014 年3 月-2016 年7 月青海省人民医院收治的脑卒中患者142 例。依据颈动脉超声检查结果分为无狭窄组、轻度狭窄组、中度狭窄组、重度狭窄组，比较4 组患者的超声指标、脑白质病变率及MMSE 评分。结果 无狭窄组、轻度狭窄组、中度狭窄组、重度狭窄组患者的狭窄率、收缩期峰值流速、内膜中层厚度比较，均依次升高，经F 检验，差异具有统计学意义（P <0.05）；无狭窄组、轻度狭窄组、中度狭窄组、重度狭窄组患者的脑白质病变率比较，经χ2 检验，差异具有统计学意义（P <0.05），无狭窄组、轻度狭窄组、中度狭窄组、重度狭窄组患者的脑白质病变率依次升高；无狭窄组、轻度狭窄组、中度狭窄组、重度狭窄组患者的MMSE 评分比较，定向力、延迟回忆力、注意计算力、即刻回忆力、语言能力及MMSE 总分依次降低。经F 检验，差异具有统计学意义（P <0.05）。结论 颈内动脉狭窄能够增加脑卒中患者脑白质病变风险，影响患者认知水平，临床上应密切监测患者颈内动脉狭窄程度，并给予及时干预和有效治疗。

Abstract:

Objective To investigate the effect of internal carotid artery stenosis on cerebral white matter lesions and cognitive function in stroke patients. Methods This study selected 142 stroke patients in our hospital from March 2014 to July 2016. According to the results of carotid artery ultrasonography, they were divided to non-stenosis group, mild stenosis group, moderate stenosis group and severe stenosis group. The ultrasonographic indexes, rate of white matter lesions and MMSE scores were compared among the four groups. Results The stenosis rate, systolic peak velocity and intima-media thickness of the stenosis group, mild stenosis group, moderate stenosis group and severe stenosis group increased in turn (P < 0.05). The white matter lesion rate increased in turn from the stenosis group, mild stenosis group, moderate stenosis group to severe stenosis group (P < 0.05). Comparing MMSE scores of the patients, the scores of orientation, delayed recollection, attention, immediate recollection, language and total MMSE score of the non-stenosis group, mild stenosis group, moderate stenosis group and severe stenosis group decreased in turn (P < 0.05). Conclusions Internal carotid artery stenosis can increase the risk of cerebral white matter lesions in the patients with stroke and affect the cognitive level of the patients. Clinically, we should closely monitor the stenosis degree of internal carotid artery, and give timely intervention and effective treatment.