缺血性小血管病变的影像学特点与血管性痴呆的相关研究  

Study of relationship between imaging features of ischemic small vessel disease and vascular cognitive impairment

作　　者：张华[1] 李娜[2] 吴瑞鹏[2] 刘顺达[1] 李灵真[2] 罗英姿[1] 高永英[1] 蔡海燕[1] 

机构地区：[1]宁夏回族自治区人民医院神经内科,银川7500211 [2]宁夏医科大学

出　　处：《中华脑血管病杂志（电子版）》2011年第5期12-15,共4页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：宁夏科技攻关项目(No.2010168);银川市科技发展项目(No.2010452)

摘　　要：目的探讨缺血性小血管病变(SVD)的影像学特点与血管性痴呆(VD)的关系。方法选择74例经影像学(颅脑CT或颅脑MRI)证实的SVD患者,均于发病后3个月采用简易精神量表(MMSE)和蒙特利尔认知评估量表(MoCA)对其检测后分为痴呆组40例和对照组34例。结果 (1)MoCA量表对痴呆组及对照组的筛查评分均较MMSE量表评分低。(2)VD组中额叶、颞叶、基底节区、丘脑的发病者多于对照组(P<0.05)。(3)吸烟、饮酒、脑白质病变、脑萎缩、梗死次数(≥2次)、梗死部位(双侧)VD组与对照组差异有统计学意义(P<0.05)。结论 (1)缺血性SVD患者,MoCA量表筛查优于MMSE量表。(2)SVD患者病变部位、吸烟、饮酒、脑白质病变、脑萎缩、梗死次数(≥2次)、梗死部位(双侧)与VD的发生相关。Objective To explore the relationship between the imaging characteristics of ischemic small vascular disease and vascular dementia. Methods 74 patients with small vessel disease （SVD） according to MRI or CT images were divided into dementia group （40 cases） and control group （34 cases）. The patients were evaluated with mini-mental state examination（MMSE） and Montreal cognitive assessment （MoCA） after lacunar infarction （LI） 3 months. Results （1）MoCA score was much lower than MMSE score in dementia group and control group. （2）There were significant deviation in lesions of frontal lobe, temporal lobe, basal ganglia, and thalamus in vascular dementia （VD） group more than control group （P 〈 0.05 ）. （ 3 ） Smoking, alcohol, white matter lesions （ WML）, brain atrophy, infarction times （ Small vessel disease; Lacunar infarction; White matter lesions ; Vascular dementia twice）, infarction location （bilateral） in VD group were significantly higher than those in control group （ P 〈 0. 05 ）. Conclusions （ 1 ） MoCA was more sensitive than MMSE in evaluation of ischemic SVD patients. （2） The lesion location, smoking, alcohol, WML, brain atrophy, infarction times （ ≥ twice）, infarction location （ bilateral） were related to VD.

关 键 词：小血管病变 腔隙性脑梗死 脑白质病变 血管性痴呆 

分 类 号：R749.1[医药卫生—神经病学与精神病学]