急性脑卒中患者的失语亚型与经典脑皮质语言中枢的关系

Correlation between aphasia subtypes and classical brain language centers in acute stroke patients

目的揭示急性脑卒中患者的失语症类型与经典语言中枢间的关系。方法入选101例急性脑卒中失语患者,应用西部失语成套测验进行失语症分类、波士顿诊断性失语检查严重程度分级标准进行失语症严重程度分级,并行CT、MRI检查。结果病变部位位于经典语言中枢者56例（55.4%）,位于非经典语言中枢者45例（44.6%）。失语严重程度为0和1级患者中,病灶累及经典语言中枢占73.1%,显著高于严重程度为2~5级患者的26.5%（P=0.000）。结论急性脑卒中患者的失语症类型与神经影像学检查所见的病变部位的关系并不完全符合经典的失语症模式,经典语言中枢以外的更多部位都可能参与失语症的形成,经典语言中枢受累者的失语程度多较严重。

Objective To investigate the relationship between aphasia subtypes and the classical brain’s language centers in patients with acute stroke. Methods One hundred and one acute stroke patients with different subtypes of aphasia were enrolled in the present study. All patients were examined by the Western aphasia battery for typing and the Boston diagnostic aphasia examination for severity grading; the patients also underwent CT and MRI examinations. Results Fifty-six patients （55.4%） had their vascular brain lesions located at the classical language centers, and 45 （44.6%） patients outside the classical language centers. About 73.1% of the patients with Boston diagnostic aphasia grade of 0 and 1 had their lesions involving the classical language centers, which was significantly higher than those who with aphasia grade 2 to 5 （73.1 vs. 26.5%, P=0.000）. Conclusion In patients with acute stroke the types of aphasia and lesion locations do not always accord with the classical clinical-anatomic correlations as identified by CT or MRI. Lesions outside the classical language centers might also participate in the development of aphasia, and those with lesions at the classical language centers have more severe aphasia.