白质疏松与局部脑血流痴呆关系的初步探讨

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、LA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.

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

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.