The influence of the cognitive function and related dangerous factors in patients with lacunar infarction after carotid artery stenting / 中华行为医学与脑科学杂志

ABSTRACT

Objective To explore the influence of the cognitive function and related dangerous factors in patients lacunar infarction(LI) after carotid artery stenting (CAS).Methods Neuropsychological tests (MoCA and MMSE)were conducted in 43 patients with LI before CAS,1 month,6 months,1 year and 2 years after CAS and the scores were compared with those of 41 healthy cases.Results Compared with control group,in therapy group,MMSE scores before CAS,1 month and 6 months after CAS,MoCA scores before CAS(19.39 ±2.17) and 1 month after CAS(19.51 ± 1.99) and the scores of Cube Copying before CAS,Alternating Trail Making Test,attention and delayed recall before CAS,1 month after CAS and Clock Drawing before CAS,1 month and 6 months after CAS all lowered obviously.There were statistical differences(P＜ 0.05 or P ＜ 0.01).Compared with before CAS,in therapy group,MMSE scores and MoCA scores 6 months,1 year and 2 years after CAS,the scores of Alternating Trail Making Test 2 years after CAS,Cube Copying and Clock Drawing 1 year and 2 years after CAS and attention and delayed recall 6 months,1 year and 2 years after CAS all increased obviously.There were statistical differences (P ＜ 0.05 or P ＜ 0.01).In the follow-up of 2 years,the result of Logistic Regression Analysis showed that MoCA scores has correlation with age(OR =50.751,95％ CI 1.407 ～ 19.464; P =0.006),high blood pressure(0R=8.012,95％ CI1.212 ～27.550; P=0.042)and low levels of education(OR=11.586,95％ CI1.164～ 16.903 ; P =0.029) and no correlation with diabetes and CAS.Conclusion Cognitive impairment in patients with LI is improved 2 years after CAS,and visuospatial function,attention and delayed recall are significantly improved.But CAS is not independent protective factors for cognitive functions,and old age,low education levels and high blood pressure are independent risk factors for cognitive impairment in patients with LI.