关键词: 手术; 烟雾病; 认知功能

Abstract: Objective To investigate the influence of surgical and pharmacological therapies on the cognitive function of patients with adult moyamoya disease. Methods A total of 52 patients with adult moyamoya disease were included, and were divided into a surgical group and a control group according to their treatment plans. Patients in the control group were treated with conservative therapy using aspirin enteric-coated sustained release tablets, dextran 40, oxiracetam, and dexamethasone. Patients in the surgical group received surgical therapies (direct bypass operations and indirect bypass operations). The cognitive functions of patients in the two groups were assessed before treatments and 6 months after treatments to evaluate the improvement in patients’ cognitive functions. Results There was no significant difference in patients’ cognitive functions between the two groups before treatments. At 6-month follow-up, Montreal cognitive assessment(MoCA) of the patients showed that patients’ cognitive functions of the surgical group ( t =2.092, P =0.009) and the control group ( t =2.814, P =0.007) had improved significantly compared to those before treatments, respectively. Assessments using mini-mental state examination(MMSE) showed significant improvement in the surgical group ( t =2.706, P =0.005) while the control group had no significant improvement. Comparison of the curative effects between the two groups showed that the rate of therapeutic effectiveness was higher in the surgical group than in the control group, which is statistically significant (96.15% vs 84.62%, χ 2 =10.15, P <0.05). Conclusion Surgical therapy for moyamoya disease can better improve patients’ cognitive functions and clinical curative effects than pharmacological therapy.

Key words: Surgery; Moyamoya disease; Cognitive function