Stepen kognitivnog oštećenja u odnosu na cerebralne ishemijske lezije kod bolesnika sa karotidnom stenozom
Sažetak
Uvod/Cilj. Karotidna stenoza je faktor rizika od razvoja poremećaja kognitivnih funkcija. Cilj ovog istraživanja je bio da ispita stepen kognitivnog poremećaja kod bolesnika sa asimptomatskom i simptomatskom karotidnom stenozom i njegove povezanosti sa postojanjem, lokacijom i veličinom cerebralnih ishemijskih lezija. Metode. Prospektivnom analizom obuhvaćeno je 180 bolesnika starosti od 50 do 70 godina, podeljenih u tri grupe (asimptomatska i simptomatska karotidna stenoza i osobe bez stenoze karotnih aterija – kontrolna grupa). Procenjivane su demografske karakteristike i vaskularni faktori rizika, izvršeni su ultrazvučni pregled karotidnih arterija, kompjuterizovana tomografija (KT), magnetna rezonanca (MR) mozga, kao i neuropsihološko testiranje. Rezultati. Nalazi KT mozga na prijemu pokazali su lezije u levoj hemisferi kod 13,3% asimptomatskih bolesnika i 41% bolesnika u simptomatskoj grupi. U desnoj hemisferi registrovane su lezije kod 10% bolesnika u asimptomatskoj i 46,7% bolesnika u simptomatskoj grupi. Razlika između grupa bila je statistički značajna. Zapremina lezija, merena metodama KT i MR, statistički značajno se razlikovala (p < 0,001) između grupa sa asimptomatskom i simptomatskom karotidnom stenozom. Stepen kognitivnih oštećenja, meren Adenbrukovim revidiranim testom kognitivne procene (ACE-R), bio je značajno različit između grupa (p < 0,05) sa najizraženijim deficitom u simptomatskoj grupi. Zaključak. Naše istraživanje je pokazalo da je kognitivno oštećenje kod bolesnika sa simptomatskom karotidnom stenozom značajno višeg stepena od onog kod bolesnika sa asimptomatskom karotidnom stenozom.
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