Effect Of Internal Carotid Artery Stenting On Cognition And Emotion Of Patients With Severe Internal Carotid Artery Stenosis

IntentionBy comparing the effects of carotid aretery stenting(CAS)combined with medication and simple drug therapy on the cognitive and emotional improvement of patients with severe internal carotid stenosis,it can guide the follow-up treatment and improve the quality of life of patients.MethodA total of 60 patients with internal carotid artery stenosis ≥70% confirmed by Digital subtraction angiography(DSA)were collected.They were admitted to the Affiliated Cardiovascular and Cerebrovascular Hospital of Yan ’an University from June2019 to December 2020.In addition,major stroke(NIHSS≥4 points,m RS 3-5 points),malignant tumors,major liver and kidney diseases,antidepressant use and drugs that may affect cognitive use,other extracranial and intracranial vascular stenosis >50%,and other causes of stenosis(such as vasculitis)were excluded.Patients above the conditions were assigned to CAS combined with medication group(29 cases)and pure internal medicine group(31 cases)according to the random number table method.Among them,1 patient in the experimental group developed vascular restenosis after surgery,and the experimental group was excluded,so 28 patients were eventually included in CAS combined with medication.The internal carotid artery stenosis rate,whether the patients had hypertension,diabetes,hyperlipidemia,coronary heart disease,whether the patients had smoking history,years of education,The Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(Mo CA)were used to evaluate the cognitive function of the patients before intervention,Hamilton Anxiey Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the affective status of the patients before intervention.According to SPSS22.0 analysis,there was no statistical difference in baseline data between the CAS combined with medication group and the drug treatment group alone(p > 0.05),which could be compared,as shown in Tab.2-1.The CAS combined with medication group was given CAS combined with medication and conventional drug therapy,while the drug-only group was given standard internal medicine therapy.The scores of MMSE,Mo CA,HAMA and HAMD were collected before intervention and 1,3 and 6 months after intervention.Result1 Baseline data analysis:A total of 59 patients with severe internal carotid stenosis were included in this study,including 28 patients in the experimental group(CAS combined with medication group)and 31 patients in the control group(single drug group).There were no significant differences in the basic data and MMSE,Mo CA,HAMA and HAMD scores of the patients detected before treatment(p > 0.05).As shown in tab.2-1.2 Cognitive function analysis of patients in two groups:The postoperative MMSE and Mo CA scores of CAS combined with medication group at each monitoring point(1,3 and 6 months)were higher than those before surgery,with statistical significance(p <0.05).3 months after the operation was better than 1 month after the operation,6 months after the operation was better than 3 months after the operation,and the improvement was most significant at 6 months after the operation.There was no significant difference in MMSE and Mo CA scores at monitoring points(1,3 and 6 months)in drug therapy alone group(p > 0.05).Compared with the drug therapy alone group,the scores of each monitoring point in CAS combined with medication group were all higher than that in the drug therapy alone group,and the difference was statistically significant(p < 0.05).As shown in Tab.2-2,Tab.2-3.3 Analysis of affective status of patients in two groups:There was no significant difference in HAMA and HAMD scores at monitoring points(1,3 and 6 months)between the CAS combined with medication group and the drug treatment group after surgery(p > 0.05).There was no significant difference in monitoring sites between CAS combined with medication group and drug therapy group(p >0.05).As shown in Tab.2-4,Tab.2-5.Conclusion1 CAS combined with medication can improve the cognitive function scores of patients with severe internal carotid stenosis,and the improvement of cognitive function tends to be better with the prolongation of experimental observation time.2 CAS combined with medication did not significantly improve emotion in patients with severe internal carotid stenosis.3 The cognition and emotion of patients with severe internal carotid stenosis were not improved by drug therapy alone.