Yan Yongxing, Liang Lizhen, Yuan Yanrong, Chen Tao, Shen Yonghui, Zhong Changyang
Department of Neurology, Third People's Hospital, Hangzhou, China (mainland).
Med Sci Monit. 2014 Jul 3;20:1129-36. doi: 10.12659/MSM.890592.
We aimed to investigate cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis (SVAS) after stent-assisted angioplasty (SAA) and to explore the potential mechanism.
The study subjects were 26 elderly SVAS patients who were non-responsive to pharmacotherapy and received SAA (study group) and 30 patients receiving intracoronary stent implantation (control group). Montreal cognitive assessment (MoCA), Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA) were used.
The total MoCA score, scores of line connection, copying cube, drawing clock, and delayed recall increased significantly in the study group after surgery (P<0.05, P<0.01). In addition, the MoCA score increased over time and the total MoCA score at 12 months was markedly higher than that at 1 month (P<0.05). The scores of HAMD and HAMA decreased dramatically after surgery compared with before surgery in these patients (P<0.01). A comparison at the corresponding period was performed between study group and control group, and it was found that the differences in total MoCA scores and scores of line connection, copying cube, drawing clock, and delayed recall before surgery and at 1 month after surgery were significant (P<0.05, P<0.01).
SAA may improve the visuospatial/executive abilities and delayed recall, as well as the depression and anxiety in patients with SVAS. Larger and controlled trails are needed to investigate the effect of SAA on cognition and affection in these patients.
我们旨在研究有症状的椎基底动脉狭窄(SVAS)老年患者在支架辅助血管成形术(SAA)后的认知功能和情感障碍,并探讨其潜在机制。
研究对象为26例对药物治疗无反应且接受SAA的老年SVAS患者(研究组)和30例接受冠状动脉内支架植入术的患者(对照组)。采用蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)。
研究组术后MoCA总分、连线测验、临摹立方体、画钟测验及延迟回忆得分均显著提高(P<0.05,P<0.01)。此外,MoCA得分随时间增加,术后12个月的MoCA总分显著高于术后1个月(P<0.05)。这些患者术后HAMD和HAMA得分较术前显著降低(P<0.01)。对研究组和对照组在相应时间段进行比较,发现术前及术后1个月MoCA总分、连线测验、临摹立方体、画钟测验及延迟回忆得分的差异有统计学意义(P<0.05,P<0.01)。
SAA可能改善SVAS患者的视觉空间/执行能力和延迟回忆,以及抑郁和焦虑症状。需要开展更大规模的对照试验来研究SAA对这些患者认知和情感的影响。