作者：闫灵娟，阴玮玮，金京兰，王佳

单位：

710038陕西省西安市，空军军医大学第二附属医院超声科

Units：

Department of Ultrasound, Second Affiliated Hospital of Air Force Military Medical University, Xi'an 710038, China

关键词：

颈动脉狭窄；颈动脉内膜剥脱术；认知；颈动脉；血流速度

Keywords：

Carotid stenosis; Carotid endarterectomy; Cognition; Carotid arteries; Blood flow velocity

CLC：

R 543.4

DOI：

10.12114/j.issn.1008-5971.2024.00.072

Funds：

陕西省卫生健康委员会科研项目（20210255）

摘要：

目的　分析重度颈动脉狭窄患者颈动脉内膜剥脱术（CEA）后认知功能、颈动脉血流速度的侧别差异 及其相关性。方法　选取2019年1月—2022年1月在空军军医大学第二附属医院接受CEA并进行认知功能评估的重度颈 动脉狭窄患者120例为研究对象，其中左侧病变58例、右侧病变62例。比较左侧病变患者和右侧病变患者一般资料及 CEA后认知功能〔神经行为认知状态检查（NCSE）量表、额叶功能评定量表（FAB）评分〕、患侧颈动脉血流速度指 标〔收缩期峰值流速（PSV）、舒张末期血流速度（EDV）、搏动指数（PI）〕。分析左、右侧病变患者CEA后NCSE 量表、FAB评分与颈动脉血流速度指标间的相关性。结果　右侧病变患者CEA后NCSE量表、FAB评分高于左侧病变患 者（P＜0.05）。左侧病变患者和右侧病变患者CEA后PSV、EDV、PI比较，差异无统计学意义（P＞0.05）。左侧病变 患者CEA后NCSE量表、FAB评分与EDV、PI呈正相关（P＜0.05），而与PSV无直线相关关系（P＞0.05）；右侧病变患 者CEA后NCSE量表、FAB评分与EDV呈正相关（P＜0.05），而与PSV、PI无直线相关关系（P＞0.05）。结论　左侧 重度颈动脉狭窄患者CEA后认知功能差于右侧重度颈动脉狭窄患者，但二者的颈动脉血流速度无差异；左侧重度颈动 脉狭窄患者CEA后认知功能与颈动脉EDV、PI呈正相关，右侧重度颈动脉狭窄患者CEA后认知功能与颈动脉EDV呈正 相关。

Abstract：

Objective To analyze the lateral differences and correlation in cognitive function and carotid blood flow velocity in patients with severe carotid artery stenosis after carotid endarterectomy (CEA) . Methods A total of 120 patients with severe carotid artery stenosis who received CEA and underwent cognitive function assessment at Second Affiliated Hospital of Air Force Military Medical University from January 2019 to January 2022 were selected as the study objects, including 58 patients with left side lesions and 62 patients with right side lesions. The general data and cognitive function [Neurobehavioral Cognitive Status Examination (NCSE) scale, Frontal Assessment Battery (FAB) scores] and carotid blood flow velocity indexes [peak systolic velocity (PSV) , end diastolic velocity (EDV) , and pulsatility index (PI) ] on the affected side after CEA were compared between patients with left lesion and patients with right lesion. The correlation between NCSE scale, FAB score, and carotid blood flow velocity indexes after CEA in patients with left and right lesions was analyzed. Results The NCSE scale and FAB scores of patients with right side lesions after CEA were higher than those of patients with left side lesions (P < 0.05) . There was no statistically significant difference in PSV, EDV, and PI between patients with left lesions and patients with right lesions after CEA (P > 0.05) . In patients with left lesions, the NCSE scale and FAB scores after CEA were positively correlated with EDV and PI (P < 0.05) , but not linearly correlated with PSV (P > 0.05) ; in patients with right lesions, the NCSE scale and FAB scores after CEA were positively correlated with EDV (P < 0.05) , but not linearly correlated with PSV and PI (P > 0.05) . Conclusion The cognitive function after CEA in patients with left severe carotid artery stenosis was worse than that in patients with right severe carotid artery stenosis, but there was no difference in carotid blood flow velocity between the two. The cognitive function after CEA was positively correlated with EDV and PI of carotid arteries in patients with left severe carotid artery stenosis, and positively correlated with EDV of carotid arteries in patients with right severe carotid artery stenosis.

ReferenceList：