Correlation between Internal Carotid Artery Stenosis and Cognitive Impairment
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摘要:
目的 了解不同程度及不同侧别的颈内动脉狭窄与认知功能障碍的相关性。 方法 连续选取2017年6月至2018年8月期间，某医院神经内科接受CTA或DSA检查脑血管的患者，根据根据检查结果将研究对象分为狭窄组和对照组。对所有入组患者进行记忆测评量表+改良版WCST检查，记录测评得分，统计分析各组别患者的得分差异。总纳入65例，根据狭窄与否分为狭窄组（共34例）和对照组（共31例），根据狭窄程度将狭窄组分为轻度狭窄组（共15例）和中重度狭窄组（共19例），根据侧别将狭窄组分为左侧狭窄组（24例）和右侧狭窄组（10例）。 结果 狭窄组与对照组记忆及执行能力均显著受损，差异有统计学意义（P < 0.05）。狭窄程度及狭窄侧别与记忆及执行能力无相关性，差异均无统计学意义（P > 0.05）。 结论 颈内动脉狭窄显著影响患者以记忆、执行能力为代表的认知功能，但狭窄严重程度及狭窄侧别与认知功能无关。 Abstract:Objective To investigate the correlation of different degrees and sides of internal carotid artery stenosis with cognitive impairment. Methods From June 2017 to August 2018, patients for cerebrovascular examination with CTA or DSA were selected from the neurology department of a certain hospital. They were divided into the stenosis group and the control group according to the examination results. All the enrolled patients were examined with memory assessment scale+modified WCST. The assessment scores were recorded and the difference of scores among the patients in each group was statistically analyzed. Results 65 cases were included in the study, which were divided into stenosis group （34 cases in total） and control group （31 cases in total） according to the examination results.The stenosis group was divided into mild stenosis group （15 cases in total） and moderate severe stenosis group （19 cases in total） according to the degree of stenosis. And the stenosis group was again divided into left stenosis group （24 cases in total） and right stenosis group （ 10 cases in total） according to the side. The memory and executive ability of the stenosis group and the control group were significantly impaired, the difference was statistically significant （P < 0.05）. The degree and side of stenosis had no correlation with memory and executive ability, and the difference was not statistically significant （P > 0.05）. Conclusion Internal carotid artery stenosis significantly affects cognitive function as indicated by memory and executive ability. However, the severity and side of stenosis are not related to cognitive function. -
图 1 狭窄组与对照组记忆测评及改良法WCST得分比较
*P < 0.05。
Figure 1. Comparison of memory assessment and WCST scores of the stenosis group and the control group
图 2 轻度狭窄组、中重度狭窄组与对照组记忆测评及改良法WCST得分比较
*P < 0.05。
Figure 2. Comparison of WCST scores in memory assessment and modified method between mild stenosis group，moderate-severe stenosis group and control group
图 3 左侧狭窄组、右侧狭窄组与对照组记忆测评及改良法WCST得分比较
*P < 0.05。
Figure 3. Comparison of memory assessment and WCST score of the left stenosis group，right stenosis group and control group
表 1 狭窄组与对照组一般临床资料[n（%）/
$\bar x \pm s $ ]Table 1. General clinical data of stenosis group and control group [n（%）/
$\bar x \pm s $ ]变量 狭窄组（n = 34） 对照组（n = 31） 检验值（t/χ2） P 年龄 65.03 ± 7.54 60.16 ± 9.55 1.876 0.066 受教育程度（a） 7.35 ± 3.15 8.42 ± 3.15 −1.363 0.178 BMI（kg/m2） 23.25 ± 3.09 24.31 ± 2.28 −1.555 0.125 高脂血症史 14（41.2） 17（54.8） 1.213 0.271 男性 19（55.9） 14（45.2） 0.746 0.388 高血压病史 23（67.6） 17（54.8） 1.124 0.289 糖尿病病史 8（23.5） 4（12.9） 1.216 0.27 吸烟 18（52.9） 10（32.3） 2.829 0.093 饮酒 14（41.2） 8（25.8） 1.711 0.191 
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表 2 狭窄组与对照组记忆测评及改良法WCST得分比较（
$\bar x \pm s $ ）Table 2. Comparison of memory assessment and WCST scores of the stenosis group and the control group （
$\bar x \pm s $ ）组别 狭窄组（n = 34） 对照组（n = 31） t P 记忆测评 40.44 ± 19.92 57.77 ± 17.94 −3.672 < 0.001* 改良法WCST 6.62 ± 2.84 8.42 ± 1.43 −3.272 0.002* *P < 0.05。
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表 3 轻度狭窄组、中重度狭窄组与对照组记忆测评及改良法WCST得分比较（
$\bar x \pm s $ ）Table 3. Comparison of WCST scores in memory assessment and modified method between mild stenosis group，moderate-severe stenosis group and control group （
$\bar x \pm s $ ）组别 轻度狭窄组（n = 15） 中重度狭窄组（n = 19） 对照组（n = 31） F P 记忆测评 45.63 ± 16.65 36.34 ± 21.72 57.78 ± 17.94 7.872 0.001* 改良法WCST 6.80 ± 2.89 6.47 ± 2.88 8.42 ± 1.43 5.080 0.009* *P < 0.05。
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表 4 左侧狭窄组、右侧狭窄组与对照组的记忆测评及改良法WCST得分比较（
$\bar x \pm s $ ）Table 4. Comparison of memory assessment and WCST score of the left stenosis group，right stenosis group and control group （
$\bar x \pm s $ ）组别 左侧狭窄组（n = 24） 右侧狭窄组（n = 10） 对照组（n = 31） F P 记忆测评 41.69 ± 19.64 37.45 ± 21.36 57.78 ± 17.94 6.847 0.002* 改良法WCST 7.25 ± 2.33 5.10 ± 3.48 8.42 ± 1.43 8.962 < 0.001* *P < 0.05。
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