颈动脉斑块负荷的测量：一种预测和预防痴呆症的工具？
Measurement of carotid plaque burden: A tool for predicting and preventing dementia?
作者信息
Shin John J, Hachinski Vladimir, Azarpazhooh M Reza, Shariatzadeh Aidin, Spence J David
机构信息
Medical Student, Faculty of Medicine, University of Ottawa, Canada.
Department of Clinical Neurological Sciences, Western University, London, ON, Canada.
出版信息
Cereb Circ Cogn Behav. 2021 Jan 30;2:100004. doi: 10.1016/j.cccb.2021.100004. eCollection 2021.
INTRODUCTION
Carotid plaque burden is a strong predictor of stroke risk, and preventing stroke reduces the risk of dementia. Treating carotid plaque burden markedly reduces the risk of stroke.
METHODS
Among patients age 65-80 years attending a stroke prevention clinic, we identified those with a carotid plaque burden in the top 20% of Total Plaque Area (High TPA) and the bottom 20% (Low TPA) and performed cognitive tests: The Montreal Cognitive Assessment test (MoCA), the WAIS-III Digit Symbol-Coding Test (DSST) and Trail-Making Test (TMT) part A and B.
RESULTS
There were 31 patients recruited; 11 Low TPA (5 men) and 20 High TPA (17 men), = 0.04. TPA was 35 ± 25 mm in the Low TPA vs.392 ± 169 mm in the High TPA group (0.0001). Patients with a high plaque burden had significantly worse performance on all the cognitive tests, all < 0.05.
DISCUSSION
A high carotid plaque burden identifies patients at risk of cognitive impairment. Because carotid plaque burden is treatable, and treating it markedly reduces the risk of stroke, we suggest that measurement of plaque burden is a useful tool for both prediction of cognitive impairment, and prevention of dementia.
引言
颈动脉斑块负荷是中风风险的有力预测指标，预防中风可降低患痴呆症的风险。治疗颈动脉斑块负荷可显著降低中风风险。
方法
在一家中风预防诊所就诊的65至80岁患者中，我们确定了那些颈动脉斑块负荷处于总斑块面积前20%（高TPA）和后20%（低TPA）的患者，并进行了认知测试：蒙特利尔认知评估测试（MoCA）、韦氏成人智力量表第三版数字符号编码测试（DSST）以及连线测验（TMT）A部分和B部分。
结果
共招募了31名患者；11名低TPA患者（5名男性）和20名高TPA患者（17名男性），P = 0.04。低TPA组的TPA为35 ± 25平方毫米，而高TPA组为392 ± 169平方毫米（P < 0.0001）。斑块负荷高的患者在所有认知测试中的表现明显更差，均P < 0.05。
讨论
高颈动脉斑块负荷可识别出有认知障碍风险的患者。由于颈动脉斑块负荷是可治疗的，且治疗可显著降低中风风险，我们建议测量斑块负荷是预测认知障碍和预防痴呆的有用工具。
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