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目的探讨脑梗死患者颈动脉粥样硬化与轻度认知功能损害(MCI)的相关性。方法采用蒙特利尔认知评估量表(MoCA)对380例脑梗死患者进行神经心理学测试,确诊MCI患者48例(MCI组)。选择同时期认知功能正常的脑梗死患者48例作为对照组。测定颈总动脉内膜中膜厚度(IMT)、颈动脉软斑块数,收集人口学及痴呆危险因素等方面的指标。结果 MCI组高血压病及糖尿病比例、IMT、软斑块数高于对照组(P<0.05),两组高血脂、吸烟比例无统计学差异(P>0.05)。校正了年龄、性别、受教育程度、既往病史、吸烟等因素后,颈动脉IMT的增加与MoCA分数的下降呈显著线性相关(P<0.05)。结论颈动脉IMT增加与MCI的发生、发展关系密切,颈动脉IMT增加是引起早期认知功能损害的独立危险因素。
Objective To investigate the relationship between carotid atherosclerosis and mild cognitive impairment (MCI) in patients with cerebral infarction. Methods Neuropsychological tests were performed on 380 patients with cerebral infarction using the Montreal Cognitive Assessment Scale (MoCA), and 48 patients with MCI were diagnosed (MCI group). Forty-eight patients with normal cognitive function at the same time were selected as the control group. The carotid intima-media thickness (IMT), carotid soft plaque count, collection demography and risk factors of dementia were measured. Results The rates of hypertension and diabetes mellitus, IMT and soft plaque in MCI group were higher than those in control group (P <0.05). There was no significant difference in hyperlipidemia and smoking between the two groups (P> 0.05). After adjusting for factors such as age, gender, education level, previous medical history and smoking, the increase of carotid artery IMT was significantly and linearly correlated with the decline of MoCA score (P <0.05). Conclusions The increase of carotid artery IMT is closely related to the occurrence and development of MCI. The increase of carotid IMT is an independent risk factor of early cognitive impairment.