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近红外光谱对无症状颈动脉疾病患者冠状动脉旁路移植术神经认知功能的影响:一项随机前瞻性研究。

The Effects of Near-Infrared Spectroscopy on the Neurocognitive Functions in the Patients Undergoing Coronary Artery Bypass Grafting with Asymptomatic Carotid Artery Disease: A Randomized Prospective Study.

作者信息

Kara Ibrahim, Erkin Alper, Saclı Hakan, Demirtas Mucahit, Percin Bilal, Diler Mevriye Serpil, Kırali Kaan

机构信息

Sakarya University, Faculty of Medicine, Department of Cardiovascular Surgery, Sakarya, Turkey.

出版信息

Ann Thorac Cardiovasc Surg. 2015;21(6):544-50. doi: 10.5761/atcs.oa.15-00118. Epub 2015 Jun 30.

Abstract

PURPOSE

The purpose of this study was to research the use of near-infrared spectroscopy (NIRS) on the neurocognitive functions in the patients undergoing coronary artery bypass grafting (CABG) with asymptomatic carotid artery disease.

METHODS

The study design was carried out with the participation of 79 patients in a prospective, randomized and double blind control method. The patients were separated into two groups as NIRS (n = 43) and no NIRS (n = 36). A neurocognitive test was applied preoperatively and postoperatively to all patients before discharge. Cognitive functions were evaluated by applying the Montreal Cognitive Assessment test (MoCA).

RESULTS

The decrease in the postoperative score of mean MoCA in no NIRS group was statistically significant when compared to preoperatively (p <0.001). Postoperative mean MoCA score was found to be significantly higher in NIRS group (NIRS: 26.8 ± 1.9 vs. no NIRS: 23.6 ± 2.5, p <0.001). It has been determined that there was a moderately positive significant correlation between the increase in the NIRS used patients (%) and increase in the MoCA score of the patients (r = 0.59, p <0.001).

CONCLUSION

Intraoperative NIRS usage in the patients undergoing CABG with carotid artery disease might be useful due to its postoperative positive effects on the cognitive functions.

摘要

目的

本研究旨在探讨近红外光谱技术(NIRS)在无症状性颈动脉疾病的冠状动脉旁路移植术(CABG)患者神经认知功能方面的应用。

方法

本研究采用前瞻性、随机、双盲对照方法,纳入79例患者。患者被分为两组,即NIRS组(n = 43)和非NIRS组(n = 36)。所有患者在术前和出院前术后均进行神经认知测试。通过蒙特利尔认知评估测试(MoCA)评估认知功能。

结果

与术前相比,非NIRS组术后MoCA平均得分的降低具有统计学意义(p <0.001)。发现NIRS组术后MoCA平均得分显著更高(NIRS组:26.8 ± 1.9 vs. 非NIRS组:23.6 ± 2.5,p <0.001)。已确定使用NIRS的患者增加比例(%)与患者MoCA得分增加之间存在中度正相关(r = 0.59,p <0.001)。

结论

对于患有颈动脉疾病的CABG患者,术中使用NIRS可能因其对认知功能的术后积极影响而有益。

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