椎动脉起始部支架置入术对首发颞叶或丘脑梗死患者认知功能的影响

胡耀芝; 崔珊珊; 张立功; 高琳芝

doi:10.7619/jcmp.20240787

椎动脉起始部支架置入术对首发颞叶或丘脑梗死患者认知功能的影响

1.
胜利油田中心医院神经内科, 山东东营, 257000
2.
胜利油田中心医院科教科, 山东东营, 257000

基金项目:

山东省医药卫生科技项目 202303071517

详细信息

通讯作者:
高琳芝, E-mail: zgsdglz@163.com

中图分类号: R742;R651.1;R445
计量
- 文章访问数: 107
- HTML全文浏览量: 16
- PDF下载量: 12
出版历程
- 收稿日期: 2024-02-26
- 修回日期: 2024-04-23
- 网络出版日期: 2024-07-19
- 刊出日期: 2024-07-14

Impact of stenting at the origin of vertebral artery on cognitive function in patients with first-onset temporal or thalamic infarction

1.
Department of Neurology, Central Hospital of Shengli Oilfield, Dongying, Shandong, 257000
2.
Department of Scientific Research and Education, Central Hospital of Shengli Oilfield, Dongying, Shandong, 257000

摘要

摘要:
目的
探讨椎动脉起始部(VAO)支架置入术对首发颞叶梗死或丘脑梗死患者认知功能的影响。
方法
选取65例首发颞叶或丘脑梗死患者作为研究对象, 均经颅脑磁共振成像(MRI)检查确诊颞叶内侧或丘脑单一部位新发梗死，且经头颈计算机断层血管造影(CTA)检查明确重度狭窄的VAO为梗死责任血管。将35例接受VAO支架置入术治疗的患者纳入支架组，将30例接受药物保守治疗的患者纳入对照组，比较2组患者治疗前、治疗后14 d、治疗后3个月时蒙特利尔认知评估量表(MoCA)、韦氏成人智力量表-数字广度测验(WAIS-DS)、Fuld物体记忆测验量表(FOM)评分。
结果
治疗前, 2组患者各量表评分比较，差异无统计学意义(P>0.05);治疗后14 d、治疗后3个月时，支架组的MoCA总分和视空间与执行功能、延迟回忆、语言维度评分均高于对照组，差异有统计学意义(P < 0.05);支架组治疗后3个月时的FOM评分高于对照组，差异有统计学意义(P < 0.05)。
结论
VAO支架置入术可显著改善颞叶梗死、丘脑梗死患者的认知功能。
- 椎动脉支架 /
- 椎动脉起始部 /
- 颞叶梗死 /
- 丘脑梗死 /
- 认知功能
Abstract:
Objective
To investigate the impact of stenting at the origin of vertebral artery (VAO) on cognitive function in patients with first-onset temporal or thalamic infarction.
Methods
A total of 65 patients with first-onset temporal or thalamic infarction were selected as research subjects, and were diagnosed with new-onset infarction in the medial temporal lobe or thalamus by craniocerebral magnetic resonance imaging (MRI), and severe stenosis of VAO as the responsible vessel for infarction was confirmed by head and neck computed tomography angiography (CTA). A total of 35 patients who received VAO stenting were included in the stenting group, and 30 patients who received drug-based conservative treatment were included in the control group. The Montreal Cognitive Assessment Scale (MoCA), Wechsler Adult Intelligence Scale-Digit Span Test (WAIS-DS), and Fuld Object Memory Evaluation Scale (FOM) scores were compared between the two groups before treatment, 14 days and 3 months after treatment.
Results
Before treatment, there was no significant difference in the scores of each scale between the two groups (P>0.05). At 14 days and 3 months after treatment, the total MoCA score and the scores of visual space and executive function, delayed recall, and language dimension in the stenting group were higher than those in the control group (P < 0.05). The FOM score in the stenting group was higher than that in the control group at 3 months after treatment (P < 0.05).
Conclusion
Stenting can significantly improve the cognitive function of patients with temporal lobe and thalamic infarction.
- vertebral artery stent /
- origin of vertebral artery /
- temporal lobe infarction /
- thalamic infarction /
- cognitive function

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表 1 支架组和对照组患者一般资料比较(x±s)[n(%)]

指标	分类	支架组(n=33)	对照组(n=27)	t/χ²	P
年龄/岁		62.94±8.11	64.63±6.91	0.858	0.394
性别	男	19(57.58)	16(59.26)	0.130	0.896
	女	14(42.42)	11(40.74)
既往史	吸烟	22(66.67)	15(55.56)	0.873	0.383
	饮酒	13(39.39)	9(33.33)	0.481	0.631
	高血压病	19(57.58)	17(62.96)	0.420	0.674
	糖尿病	13(39.39)	21(77.78)	0.481	0.631
	心房纤颤	5(15.15)	9(33.33)	0.345	0.730
	冠状动脉粥样硬化心脏病	10(30.30)	12(44.44)	1.096	0.273
低密度脂蛋白/(mmol/L)		2.09±1.09	1.97±0.82	0.458	0.648
高密度脂蛋白/(mmol/L)		1.98±0.52	2.23±1.08	1.183	0.242
尿酸/(μmol/L)		359.58±125.15	340.56±136.12	0.563	0.576
同型半胱氨酸/(μmol/L)		11.70±6.41	10.41±5.40	0.831	0.409

下载: 导出CSV

表 2 2组患者不同时点认知功能评分比较(x±s) 分

指标		支架组(n=33)			对照组(n=27)
指标		治疗前	治疗后14 d	治疗后3个月	治疗前	治疗后14 d	治疗后3个月
MoCA评分	总分	19.65±4.08	21.08±2.98^*	22.62±3.28^*	20.56±4.13	17.80±4.38	19.32±3.99
	视空间与执行功能	2.17±0.71	2.20±0.63^*	2.43±0.56^*	2.12±0.78	1.80±0.58	2.00±0.49
	命名	2.20±0.87	2.00±0.87	2.02±0.86	2.08±0.86	1.72±0.84	1.72±0.84
	注意力	2.20±0.83	2.06±0.87	2.03±0.86	2.20±0.76	1.72±0.84	1.92±0.81
	语言	1.97±0.82	2.83±0.38^*	2.40±0.60^*	2.16±0.85	1.44±0.65	1.84±0.55
	抽象思维	1.34±0.48	1.34±0.48	1.37±0.49	1.48±0.51	1.44±0.51	1.48±0.51
	延迟回忆	2.46±0.98	2.91±0.98^*	3.46±1.09^*	2.56±1.08	2.24±0.88	2.52±0.96
	定向	2.71±1.41	2.71±1.41	2.69±1.41	2.44±1.26	2.68±1.31	2.44±1.16
FOM评分		10.66±3.73	10.48±3.78	13.51±2.27^*	10.36±2.99	10.68±2.84	11.80±2.69
WAIS-DS评分		8.08±2.45	9.62±1.85	9.06±2.25	8.60±2.18	9.48±1.96	9.60±1.87
MoCA: 蒙特利尔认知评估量表; WAIS-DS: 韦氏成人智力量表-数字广度测验; FOM: Fuld物体记忆测验量表。与同一时点对照组比较, * P < 0.05。

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