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血管性痴呆患者颅脑影像学改变与认知功能障碍的关系探讨
引用本文:郑健,赵莘瑜,李凤鹏.血管性痴呆患者颅脑影像学改变与认知功能障碍的关系探讨[J].第三军医大学学报,2004,26(15):1391-1394.
作者姓名:郑健  赵莘瑜  李凤鹏
作者单位:第三军医大学新桥医院神经内科,重庆,400037
摘    要:目的探讨血管性痴呆患者颅脑影像学改变特点及其与认知功能障碍的关系.方法采用MRI技术测定30例缺血性血管性痴呆患者和30例正常对照者脑叶和海马体积.采用CT技术测定30例缺血性血管性痴呆和30例缺血性卒中对照患者脑室和脑沟线性指标.应用MMSE、BSSD和RSPM评定受试者认知功能.结果血管性痴呆组与卒中对照组和正常对照组比较,额叶和颞叶体积显著较小(P<0.05),海马结构、顶叶和枕叶体积无显著差异(P>0.05).额叶和颢叶体积减小的程度与MMSE、BSSD评分的降低呈正相关.病灶位于额叶和颞叶、多发病灶以及病灶总体积大于50 mm3的血管性痴呆患者认知功能减退更加显著(P<0.05).结论额叶和颞叶萎缩是发生血管性痴呆的危险因素.关键部位病变、病灶数量和病灶体积是影响血管性痴呆患者认知功能的重要因素.

关 键 词:血管性痴呆  认知障碍  颅脑CT  颅脑MRI
文章编号:1000-5404(2004)15-1391-04
修稿时间:2004年5月17日

Relationship between characteristics of brain-imaging and cognitive disorders in vascular dementia patients
ZHENG Jian,ZHAO Xin yu,LI Feng peng.Relationship between characteristics of brain-imaging and cognitive disorders in vascular dementia patients[J].Acta Academiae Medicinae Militaris Tertiae,2004,26(15):1391-1394.
Authors:ZHENG Jian  ZHAO Xin yu  LI Feng peng
Abstract:Objective To investigate the characteristics of brain imaging and its relationship with the cognitive disorders in vascular dementia patients. Methods The volumes of cerebral lobes and hippocampus formation in 30 ischemic vascular dementia patients and 30 normal controls were measured with MRI based technique. The indices of ventricles and cerebral sulci in 30 ischemic vascular dementia patients and 30 patients with ischemic stroke were calculated with CT based technique. The cognitive functions were assessed by psychometric testing (Mini Mental State Examination MMSE, Brief Screening Scale for Dementia BSSD, Raven's Standard Progress Matric RSPM) in all subjects. Results The volumes of frontal and temporal lobes in vascular dementia patients were smaller than those in ischemic stroke patients and normal control subjects ( P <0.05), but no significant difference was found in the volumes of parietal lobe, occipital lobe, and hippocampal formation ( P >0.05). The decrease of the volumes of the frontal and temporal lobes were positively correlated with the decrease of MMSE and BSSD scores. The cognitive disorders were more severe in the ischemic vascular dementia patients with pathological foci in the frontal and temporal lobes, multiple infarcts, and the total volume of infarcts greater than 50 mm 3 ( P <0.05). Conclusion The atrophy of the frontal and temporal lobes is a risk factor for vascular dementia. Strategic location, number and volume of ischemic lesions may have important impact on the cognitive functions of vascular dementia patients.
Keywords:ischemic vascular dementia  cognitive disorder  brain CT  brain MRI
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