【摘要】 目的分析高龄老人不同程度脑白质损害(WML)的临床特征、血管危险因素及其与动脉硬化和脑血流动力学关系。方法根据头颅MRI将151例高龄WML患者严重程度分级,分析不同级别高龄WML患者血管危险因素、颈动脉斑块指数(Crouse积分)、劲内动脉内膜厚度和颅内各血管脑血流量(Vm)和搏动指数(PI)的差异。结果 151例中,WML 0级62例,1级46例,2级43例。WML 2级患者高血压、吸烟比例高于WML 1级和0级患者(P<0.05),WML 2级Crouse积分高于WML 1级和0级患者(P<0.05),WML 2级患者ICARPI、MCALPI和BAPI高于WML 0级患者(P<0.05)。结论高血压、吸烟和颈动脉粥样斑块是高龄WML患者的血管危险因素。WML患者脑小血管阻力增加,其分布方式可能与高血压动脉粥样硬化的发病一致。更多还原

【Abstract】 Objective To analyze the relationship of clinical features and vascular risk factors with atherosclerosis and the cerebral hemodynamic changes in aged patients with white matter lesions(WML).Methods The severity of WML patients were graded and vascular risk factors,carotid atherosclerotic plaque score,the cerebral blood flow and pulsatility index(PI)of intracranial vessels in the patients with different grades were analyzed.Results Of 151 patients,62cases were assigned in WML 0grade,43 cases WML 1grade,and 43 cases WML 2grade.The percentages of hypertension and cigarette smorking history were higher in the patients with WML 2grade than those in those with WML 0and 1grades(P<0.05).The ICARPI,MCALPI and BAPI were higher in the patients with WML 2grade than those in those with WML 0grade(P<0.05).Conclusion Hypertension,smoking and carotid artery plaque are the important risk factors for vascular lesions in the patients with WML.The small cerebral vascular resistance is incresased in WML patients and its distribution may be consistent with the incidence of hypertensive atherosclerosis.更多还原