Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China,
Clin Interv Aging. 2019 Jan 18;14:167-177. doi: 10.2147/CIA.S192586. eCollection 2019.
To retrospectively investigate the possible association between carotid artery calcification score (CS) and cognitive impairment in carotid artery stenosis (CAS) patients.
Carotid artery was measured in 102 patients with cervical carotid arteries using Color Doppler ultrasound, multi-detector row spiral CT angiography and MRI scanning. Correlation analysis between CSs obtained by MD CT and cognitive scores was performed, and the correlation between CSs and vascular stenosis degree and MRI-measured plaque histological (lipid-rich necrotic nucleus [LRNC], intraplaque hemorrhage and fibrous cap surface rupture) and morphological parameters (lumen area [LA], wall area [WA], total area of blood vessels [TVA], plaque burden [PB]) was analyzed. Follow-up review analysis was conducted on 38 postoperative patients.
Significant negative correlation was discovered between CS value and cognitive scores in CAS patients (=-0.359, <0.001), which did not exist in postoperative patients (=0.348); CS value also showed significant correlation with WA (=0.521, =0.042), TVA (=0.215, =0.017) and PB (=0.237, =0.003) and had a certain predictive value for the occurrence probability of carotid plaque LRNC (=0.029, AUC =0.780) in preoperative patients.
Carotid artery CSs have significant correlation with cognitive scores, which could be used as risk factor for early screening of cognitive impairment in CAS patients. The possible mechanism may be related to the calcification impact on the plaque burden.
回顾性研究颈动脉狭窄（CAS）患者颈动脉钙化评分（CS）与认知障碍之间的可能关联。
对 102 例颈总动脉患者采用彩色多普勒超声、多层螺旋 CT 血管造影和 MRI 扫描测量颈动脉。对 MD CT 获得的 CS 与认知评分进行相关分析，并分析 CS 与血管狭窄程度以及 MRI 测量的斑块组织学（富含脂质的坏死核 [LRNC]、斑块内出血和纤维帽表面破裂）和形态学参数（管腔面积 [LA]、壁面积 [WA]、血管总面积 [TVA]、斑块负荷 [PB]）之间的相关性。对 38 例术后患者进行随访复查分析。
在 CAS 患者中，CS 值与认知评分呈显著负相关（=-0.359，<0.001），而术后患者则不存在这种相关性（=0.348）；CS 值与 WA（=0.521，=0.042）、TVA（=0.215，=0.017）和 PB（=0.237，=0.003）呈显著相关，对术前患者颈动脉斑块 LRNC 发生概率具有一定的预测价值（=0.029，AUC=0.780）。
颈动脉 CS 与认知评分有显著相关性，可作为 CAS 患者认知障碍早期筛查的危险因素。其可能的机制与斑块负荷的钙化影响有关。
