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颈动脉血运重建术后患者的认知功能——一项叙述性综述

Cognitive Functions in Patients after Carotid Artery Revascularization-A Narrative Review.

作者信息

Piegza Magdalena, Więckiewicz Gniewko, Wierzba Dawid, Piegza Jacek

机构信息

Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Tarnowskie Góry, Poland.

Independent Public Heath Care Psychiatric Hospital, 44-180 Toszek, Poland.

出版信息

Brain Sci. 2021 Oct 1;11(10):1307. doi: 10.3390/brainsci11101307.

Abstract

Carotid revascularization may lead to improved cognitive function beyond stroke prevention. This article summarizes the conclusions from available studies on the effects of carotid reperfusion procedures on cognitive function. The papers cited used different neuropsychological tests for cognitive assessment, resulting in different methodologies and the results obtained were not always convergent. However, most studies reported an improvement in neurocognitive abilities after both vascular interventions, but a more precise assessment of the specific benefits is still awaited. Clinical determinants to predict the effects of these treatments on cognitive function are still being sought, but results are not yet satisfactory. In view of these studies, carotid stenosis seems to be an independent risk factor for cognitive deterioration, and the main mechanisms responsible are embolism and cerebral hypoperfusion. The aim of this study is to order the knowledge about the effects of carotid artery stenting (CAS) and endarterectomy (CEA) on neurocognitive functions and to verify the usefulness of using these treatments.

摘要

颈动脉血运重建术可能在预防中风之外还能改善认知功能。本文总结了关于颈动脉再灌注手术对认知功能影响的现有研究结论。所引用的论文使用了不同的神经心理学测试来进行认知评估,导致方法各异,所得结果也并非总是一致。然而,大多数研究报告称,两种血管干预术后神经认知能力均有改善,但仍有待对具体益处进行更精确的评估。预测这些治疗对认知功能影响的临床决定因素仍在探索中,但结果尚不令人满意。鉴于这些研究,颈动脉狭窄似乎是认知功能衰退的一个独立危险因素,其主要机制为栓塞和脑灌注不足。本研究的目的是梳理关于颈动脉支架置入术(CAS)和颈动脉内膜切除术(CEA)对神经认知功能影响的知识,并验证使用这些治疗方法的有效性。

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