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世界核心医学期刊文摘(神经病学分册) 2006年第2期 42-42页

作者： mcKhann G.m. grega m.a. Borowicz Jr. L.m. 赵天智 338 Krieger Hall Johns Hopkins University 3400 North Charles Street Baltimore MD 21218 United States.Dr

Background: It is widely assumed that decline in cognition after coronary artery bypass grafting (CABG) is related to use of the cardiopulmonary bypass pump. Because most studies have not included com.a.able control groups, it remains unclear whether postoperative cognitive changes are specific to cardiopulmonary byp ass, general aspects of surgery, or vascular pathologies of the aging brain. met hods: This nonrandomized study included four groups: CABG patients (n = 140); of f-pump coronary surgery (n = 72); nonsurgical cardiac controls (NSCC) with diag nosed coronary artery disease but no surgery (n = 99); and heart healthy control s (HHC) with no cardiac risk factors (n = 69). Subjects were evaluated at baseli ne (preoperatively), 3 months, and 12 months. Eight cognitive domains and a glob al cognitive score, as well as depressive and subjective symptoms were analyzed. Results: At baseline, patients with coronary artery disease (CABG, off-pump, a nd NSCC) had lower performance than the HHC group in several cognitive domains. By 3 months, all groups had improved. From 3 to 12 months, there were minimal in trasubject changes for all groups. No consistent differences between the CABG an d off-pump patients were observed. Conclusions: Com.a.ed with heart healthy con trols (HHC), the groups with coronary artery disease had lower cognitive test sc ores at baseline. There was no evidence that the cognitive test performance of c oronary artery bypass grafting (CABG) patients differed from that of control gro ups with coronary artery disease over a 1-year period. This study emphasizes th e need for appropriate control groups for interpreting longitudinal changes in c ognitive performance after CABG.

关键词：认知功能 CABG 患者受试者得分非手术冠状动脉疾病

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