白质疏松与局部脑血流痴呆关系的初步探讨  

An analysis of leukoaraiosis in relation with regional cerebral blood flow and dementia

作　　者：何秋[1] 王幕一[2] 付峻[1] 赵丽芬[1] 陈晓虹[1] 李亚明[3] 

机构地区：[1]辽宁省人民医院神经内科,辽宁沈阳110015 [2]中国医科大学第一临床医院神经内科,辽宁沈阳110001 [3]中国医科大学第一临床医院核医学科,辽宁沈阳110001

出　　处：《中风与神经疾病杂志》2001年第6期363-365,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的 探讨白质疏松（ＬＡ）患者的局部脑血流（ｒＣＢＦ）变化及与痴呆之间的关系。方法 采用单光子发射计算断层扫描（ＳＰＥＣＴ），测定２４例伴有ＬＡ［ＬＡ（＋）］、２５例不伴有ＬＡ［ＬＡ（－）］的多发性脑梗死患者及１０例正常对照者的ｒＣＢＦ，并进行智能评分及相关分析。结果 与［ＬＡ（－）］组相比，［ＬＡ（＋）］组患者额叶及顶叶皮质上Ａ区域的ｒＣＢＦ显著减少（Ｐ＜０．０５）；痴呆例除颞叶皮质外各脑区ｒＣＢＦ均减少（Ｐ＜０．０５．Ｐ ＜０．０１）：非痴呆例仅额叶皮质与ＬＡ区域、颞叶皮质ｒＣＢＦ减少（Ｐ＜０．０５）；ＬＡ（＋）组长谷川智能评分与额叶皮质及ＬＡ区域ｒＣＢＦ呈正相关（ｒ分别为０．７６５，０．４３９）。结论 ＬＡ（＋）的多发性脑梗死患者ＬＡ区域及皮质区域灌流不足，持续低流状态可引起脑神经机能低下，进而促进痴呆发生。Objective To investigate change of regional cerebral blood flow(rCBF)and evluate the relation- ship among the leukoaraiosis(LA) , rCBF and dementia. Methods SPECT were performed in 49 cases of patients with multiple cerebral infarction, including 24 cases companying LA[LA (+)], 25 cases non- companying [LA (-)] and the normal subjects. The mental score and related analysis were performed. Results Compared with LA[LA(-)]group, rCBF of LA[LA(+)] group in the frontal cortex( P <0. 05)and parietal coxtex( P <0.05). LA region( P <0. 05) showed a significant reduction . In the demental patients with LA showed a significant re- duction of TCBF in all cerebral regions except the temporal cortex( P <0.05. P <0.01). The non-demental patien- tas with LA showed only a significant reduction in the frontal cortex( P <0. 05) and LA region (P <0. 05). A sig- nificant positive correlation was found in LA (+) between rCBF in the fronal cortex, and in LA region and the score of HDS (r =0. 765. r =0. 439.respectively). Conclusion In the multiple infarction patients of LA(+), there are extensive hypoperfusion changes in LA lesion and cortical regions, which may is responsible for decreasd cerebral function and dementia.

关 键 词：白质疏松 脑梗死 SPECT RCBF 痴呆 CT 

分 类 号：R742[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]