ABSTRACT
Objective To explore the risk factors of cognitive impairment of elderly patients with cerebral infarction in order to provide the theoretical basis for the clinical intervention. Methods A total of 237 cases with senile cerebral infarction were selected as ours subjects who were hospitalized from Mar. 2010 to Jun. 2013 in Kailuan General Hospital Affiliated to Hebei United University. The general condition and medical history were recorded. The auxiliary examination was performed. Cerebral infarction was diagnosed based on the onset to diagnosis standard and MoCA scores of within 2 weeks. The patients with less than 26 MoCA score were diagnosed as cognitive dysfunction and otherwise were thought as normal. Single factor analysis methods and non conditional Logistic regression were applied to analyze the analysis. Results There was no significant difference in terms of incidence between patients with different gender. Patients with age more than 75 years old and lower education levels had the high incidence rate than those with younger age and high education levels( χ2=16. 661,5. 453;P﹤0. 05). The cognitive dysfunction incidence of patients with white collar was lower than those with blue collar(χ2 = 5. 458,P ﹤ 0. 05 ). And the cognitive dysfunction incidence of patients with hypertention,diabetes,heart disease and leukoaraiosis were higher than those without the above diseases(χ2 =28. 423,5. 621,7. 768,6. 070;P﹤0. 05). The incidence of patients smoking more was significantly higher than that of smoking less or no(χ2 =5. 045,P ﹤0. 05 ). Multiple factors and non conditional Logistic regression analysis showed that,67 Senile cerebral infarction patients occurred cognitive impairment within 2 weeks. The independent risk factors for its occurrence included age greater than 75 years( P=0. 000 ),diabetes mellitus( P=0. 043),hypertension(P=0. 000)and leukoaraiosis(P=0. 041). Conclusion There are many risk factors related to cognitive impairment after cerebral infarction occurred in the elderly. The intervention should take in many aspects and the risk factors should early found.
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Objective To investigate the imaging features of hippocampus and entorhinal cortex in the normal,mild cognitive impairment(MCI) and Alzheimer's disease (AD),and explore the value of diagnosing MCI and AD by using the method of MRI measuring the volume of hippocampus and entorhinal cortex.Method One hundred and twenty-two people including 42 cases of MCI,38 cases of AD,and 42 cases of noroal cognition(NC) were selected as our subjects from health examination persons both in hospital and outpatient service.All were performed general examination and neuropsychological scale evaluation.The volume of hippocampus and entorhinal cortex were measured by using MRI.The correlation between the volumetric changes of hippocampus and entorhinal cortex with scores of mini-mental state examination (MMSE) and Montreal Cognitive Assessment(MoCA) was analyzed.Results The volume of hippocampus and entorhinal cortex in the MCI group,AD group and NC group were (6.29 ± 1.13)cm3 and (2.71 ± 0.51) cm3,(6.27 ± 1.11) cm3 and (2.09 ±0.68) cm3,(7.01 ±0.92) cm3 and (3.12 ±0.34) cm3 respectively.The volume of MCI group was obviously smaller than that of NC group (P ＜ 0.05).The volume of AD group was smaller than that of NC group(P ＜0.01).The volume of AD group was obviously smaller than that of MCI group(P ＜0.01).There was positive correlation between hippocampus volume,the volume of entorhinal cortex and MMSE scores (r =0.770,0.811 ; P ＜ 0.01).Meanwhile,hippocampal volume,volume of entorhinal cortex were positive correlated with MoCA (r =0.810,0.842; P ＜ 0.01).Conclusion The atrophy of entorhinal cortex and hippocampus is closely related to cognitive disorder.The MRI measuring of the volume of entorhinal cortex and hippocampus has a potential value in diagnosing and distinguishing of MCI and NC.
ABSTRACT
BACKGROUND:Carotid artery stenting is a minimal y invasive, safe, simple intervention, which is particularly meaningful to patients with carotid artery stenosis who exhibit poor physical basis and cannot tolerate open surgery. ＜br> OBJECTIVE:To explore the clinical effect of percutaneous transluminal angioplasty and stenting for treatment of extracranial carotid artery stenosis. ＜br> METHODS:Twenty-nine patients with extracranial carotid artery stenosis, including 19 males and 10 females, age ranging from 45-78 years, were enrol ed and subjected to stenting and percutaneous angioplasty. American National Institutes of Health Stroke Scale, modified Rankin Scale and CT examination were tested before treatment and 24 hours after treatment. After 3-12 months fol ow-up, the coagulation indexes and B ultrasound of the carotid artery were reviewed. ＜br> RESULTS AND CONCLUSION:One patient exhibited the complete bifurcation occlusion of the right common carotid artery, and only the diameter of external carotid artery recovered 50.0%. The remaining patients were confirmed by angiograph that completely restored to normal levels, and the success rate was 97%. At 24 hours after treatment, al the 29 patients exhibit significant improvement in the diameter of lesioned carotid artery, scores on American National Institutes of Health Stroke Scale and modified Rankin Scale (P＜0.01, P＜0.05). During the 3-12 months fol ow-up, no cerebral infarction and transient cerebral ischemia occurred and carotid artery stenosis was improved in al patients. At 6 months after operation, one patient had restenosis, and the restenosis rate was 3%. Percutaneous angioplasty combined with biological material stenting for treatment of extracranial carotid artery stenosis can obtain good clinical effects.