摘要
Abstract
Objective To evaluate the cognitive function in the patients with asymptomatic carotid stenosis(ACS) by event related potentials P300(ERP-P300),mini-mental state examination(MMSE) and Montreal Cognitive Assessment(MoCA),and to explore the risk factors of cognitive impairment.Methods A total of 179 patients with ACS,who were hospitalized and outpatient in Department of Neurology,Beijing Anzhen Hospital,Capital Medical University in 2015,were selected as the research objects.According to the degree of coronary artery stenosis,subjects were divided into no stenosis group(<30%,n=90),mild to moderate stenosis group(30%-69%,n=49) and severe stenosis group(70%-99%,n=40).The clinical data were collected,and levels of serum homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP),low density lipoprotein cholesterol(LDL-C),serum uric acid(UA),and FPG were measured.MMSE,MoCA were used to evaluate the cognitive function of patients,and ERP-P300 detection was conducted by the keypoint EMG evoked potentiometer to record the latent period and amplitude,and Fazekas score were used to evaluate degree of white matter lesions.Results There was significant difference in the detection rate of smoking and hypertension among all the groups(P<0.05).There were no significant differences in scores of ERP-P300 amplitude and MMSE among all the groups(P>0.05).The latent period of ERP-P300,and scores of MoCA and Fazekas were significantly different among all the groups(P<0.05).Among them,the MoCA score in mild to moderate stenosis group was lower than that in no stenosis group,and the MoCA score in severe stenosis group was lower than that in no stenosis group and mild to moderate stenosis group(P<0.05).The latent period of ERP-P300 in mild to moderate stenosis group was longer than that in no stenosis group,and the latent period of ERP-P300 in severe stenosis group was longer than that in no stenosis group and mild to moderate stenosis group(P<0.05).The rate of MMSE in detecting cognitive impairment of patients with ACS was 16.8%(15/89),which was lower than that of MoCA〔43.8%(39/89),x2=18.892,P<0.001〕.Multivariate Logistic regression analysis showed that hypertension〔OR=2.671,95%CI(1.877,3.609)〕,the prolonged latent period of ERP-P300 〔OR=5.014,95%CI(2.983,8.429)〕,severe carotid artery stenosis 〔OR=3.232,95%CI(1.134,9.208)〕 were risk factors of cognitive impairment of patients with ACS.Conclusion Cognitive impairment may occur in the early stage of patients with ACS,and it is associated with hypertension and degree of carotid artery stenosis.MoCA and ERP-P300 are sensitive to predicting cognitive impairment of patients with ACS,and can be used as an auxiliary examination means to evaluate cognitive impairment.关键词
颈动脉狭窄/认知障碍/事件相关电位,P300/危险因素Key words
Carotid stenosis/Cognition disorders/Event-related potentials/P300/Risk factors分类
医药卫生
