| The purpose:Imaging judged by collateral circulation in patients with carotid artery stenosis and types of collateral circulation in patients with carotid artery stenosis analysis cognitive dysfunction(POCD) relationship.Method:1 sample selection and groupingSelect since December 2013 May 2014 Affiliated Hospital of Qingdao University Medical College,neurology ward admitted MRA neck and carotid artery ultrasound confirmed 110 cases of hospitalized patients with carotid stenosis, which was used as the object of this study. 110 patients with carotid artery stenosis in patients with digital subtraction angiography technical inspection, analysis of its collateral compensation cases, depending on whether the compensation, divided into two groups,namely collateral compensatory group, no collateral compensatory group. Another medical center selected 100 cases confirmed by medical examination does not exist artery stenosis who, as a normal control group.2 Survey Methods: POCD-related questionnaire for patients to investigate the incidence of POCD,questionnaires used in the evaluation include the Montreal Cognitive Scale Scale(Mo CA), Mini Mental State Examination(MMSE), Clinical Dementia Rating(CDR), ADL(ADL), for the three groups of patients were scores, and then determine if patients have POCD.Application of the above methods are anonymous questionnaires filled out paper for recycling of questionnaire data were numbers, use EPIdata3.1 software, data entry, data entry SPSS18.0 software application after the data for statistical analysis.The result:1 carotid stenosis collateral compensatory situations: there were 60 cases of compensatory collateral circulation, compensatory collateral circulation were 50 cases did not appear. 60 cases of collateral circulation in patients with decompensated have 25 cases of anterior communicating artery open compensatory, traffic artery open after 20 cases of decompensation, seven cases before leptomeningeal anastomosis open compensatory, five cases of leptomeningeal anastomosis after opening compensatory,two cases of ophthalmic artery open, and one case of compensatory arterial anastomosis open compensatory other person.2.The degree of carotid stenosis relationship 2. compensatory collateral circulation: the different collateral circulation from the carotid artery stenosis in patients with decompensated situation can be seen, light, medium and collateral circulation in patients with severe stenosis rate was 19.2 percent,respectively,, 34.3%, 87.8%, severe stenosis collateral circulation in patients with the highest rate,significantly higher than the mild to moderate carotid stenosis patients, and the collateral circulation was significantly higher rate(8.0%), between the two groups and significant differences were statistically significant(χ2 = 25.82,34.62,92.92, P <0.05). Collateral circulation in patients withmoderate stenosis group rate slightly higher than the mild stenosis group, the difference between groups was not significant and not statistically significant(p> 0.05); compared with the control group,the difference between the two groups was statistically significant and significance(χ2 = 14.19, P<0.05). Tips and compensatory collateral circulation was positively correlated with carotid stenosis.3 of cerebral blood flow: the case of cerebral blood flow from the three groups of patients can be seen,there is collateral circulation group, no collateral circulation group, cerebral blood flow in patients in the control group were(766.87 ± 103.86) ml / min,(538.29 ± 95.44) ml / min,(1157.45 ± 98.03) ml/ min, the lowest of which cerebral blood flow in patients without collateral circulation. There collateral circulation of cerebral blood flow in patients with and without collateral value patients in the control group, the difference was significant and statistically significant(t = 8.645,10.359, P <0.05)loop group; collateral circulation in patients without brain measure blood flow compared with control group were significantly different and statistically significant(t = 17.035, P <0.05).4 carotid stenosis patients and the control group of patients with MMSE and Mo CA score: The MMSE scores of patients with carotid artery stenosis and Mo CA scores were(24. 1 ± 1.5) points,(23 8 ± 1.2.)Points, were significantly lower than the control group, there was significant difference between the groups was statistically significant, and(t = 6.452,5.637, p <0.05).5 three groups of patients with MMSE scores of the case: Time of collateral circulation in patients with sub-group orientation items, sub-items scores place disorientation, memory, computing power,language skills, ability to execute, visual spatial ability and other indicators are higher than those without collateral circulation group, but lower than the control group, the difference between groups was statistically significant and significance(p <0.05); collateral circulation in patients MMSE total score(27. 8 ± 2.1) points, obviously those without collateral circulation group(22. 5 ± 1.8), but lower than the control group(29. 3 ± 2.3) points, a significant difference between the groups was statistically significant, and(t = 4.456,6.465, p <0.05); group of patients without collateral circulation MMSE scores were significantly lower than the control group, significant differences between the two groups,with statistical significance(t = 8.342, p <0.05).6. the three groups of patients Mo CA scores: three groups of patients can be seen from the Mo CA Scale score and score situation, there is collateral circulation in patients visuospatial and executive function, naming, attention, memory, language, abstract, delayed recall, disorientation score no higher than other indicators of collateral circulation group, but still lower than the control group, the difference between groups was significant and statistically significant(p <0.05); collateral circulation group, no collateral circulation group and control group Mo CA score was(25.9 ± 1.6) points,(21. 8 ±1.2) points,(27. 1 ± 1.8) points, there is collateral circulation in patients Mo CA scores were significantly those without collateral circulation group, but lower than the control group, the difference between groups was statistically significant and significance(t = 4.379,5.762, p <0.05); group of patients without collateral circulation Mo CA scores were significantly lower than the control group, a significant difference between the groups, with statistical significance(t = 7.539, p <0.05).7 three groups of patients with clinical dementia scale(CDR) score and ADL(ADL) scores situation:The collateral circulation in patients CDR score of 0.5 points, with the same group of patients without collateral circulation between the two groups There was no significant difference(p> 0.05), but significantly higher(0 points), the difference between groups was statistically significant and significance(t = 7.356, p <0.05); collateral circulation group, no collateral circulation group and control group patients ADL scores were(16.8 ± 0.8) points,(23.2 ± 1.3) points,(14.5 ± 0.4) points,there are collateral circulation group ADL scores were significantly lower in patients No collateral circulation group, but higher than the control group, the difference between groups was statistically significant and significance(t = 5.673,5,142, p <0.05); no collateral circulation group CDR score and ADL score higher than the control group significant difference between statistical significance and(t =7.356,7.045, p <0.05).8 three groups of patients and the incidence of POCD incidence of cases of dementia: There collateral circulation group, no collateral circulation and control groups of patients the incidence of POCD were25.0%, 48.0%, 4.0%, the incidence of dementia respectively, 16.7%, 36.0%, 2.0%, there is collateral circulation group, the incidence of POCD and dementia was significantly lower than the group without collateral circulation, the difference between groups was statistically significant and significance(χ2 =6.30,5.37, P < 0.05); collateral circulation group, collateral circulation in patients without POCD and dementia incidence rates significantly higher, the difference between groups was statistically significant and significance(χ2 = 15.80,42.51; 9.61,33.35, P < 0.05).9 primary collateral circulation, secondary collateral circulation, open relationship without collateral circulation and cerebral infarction: primary collateral circulation group, secondary collateral circulation in patients with cerebral infarction incidence was 44.4%, 42.9%, were significantly lower than those without collateral circulation in patients(80.0%), the difference between groups was statistically significant and significance(χ2 = 12.87,5.74, p <0.05); but primary and secondary collateral circulation The incidence of grade collateral circulation in patients with cerebral infarction with no obvious open group does not have a statistically significant(p> 0.05).In conclusion:1 degree of carotid stenosis and collateral circulation compensatory positive correlation, the more severe carotid stenosis, the higher the collateral circulation; and cerebral blood flow was directly proportional to the carotid artery stenosis, the less cerebral blood flow.2 collateral circulation in patients with carotid artery stenosis and cognitive dysfunction compensatory situation closely, there were compensatory collateral circulation and the incidence of POCD incidence rates of dementia increased.3 stenosis or closure of collateral circulation after opening lower incidence of cerebral infarction,clinical prognosis than collateral circulation is not open well.
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