脑白质稀疏症100例CT及智能障碍分析

Intelligence impairment of 100 patients with leuko araiosis

目的： 分析脑白质稀疏症（ＬＡ）的智能评判结果．方法： ＣＴ 检查用Ｐｈｉｌｉｐｓ－Ｔｏｍ ｓｃａｎ ３５０型全身扫描机，按Ｍｉｒｓｅｎ 计分表示白质稀疏，即两侧均无病灶为０度，１～２个病灶为１度，３～５个病灶为２度，多于５个病灶为３度，融合病灶为４度． 智能检查采用长谷川量表与ＤＳＭ－４－Ｒ临床智能标准相结合， 临床表现由神经科医生询问病史及神经系检查做出．结果： １００例脑白质稀疏症中，智能无障碍２３例，轻度障碍２０例，中度障碍３４例，痴呆２３例． 智能障碍的发生率及程度与病程长短及ＬＡ的严重程度有关，ＬＡ并发多发脑梗塞中智能障碍发生率高达８３％ ． ＬＡ伴发智能障碍的临床特征主要有情感失控，尿便失禁，步态异常． 结论： ＬＡ的智能损害与ＬＡ的存在无关，而与ＬＡ的严重程度有关，ＬＡ 的存在提示随后卒中发生率增加，所以影像学上ＬＡ 的出现早于临床症状，可以了解患者的发展及预后．

AIM: To determine the relationship between CT scanning findings of leuko araiosis (LA) and intelligence impairment. METHODS: Prospective study was conducted in one hundred patients who had been identified to have LA by CT scanning and their clinical neurological examination results were analyzed. LA was divided into 0~4 degrees according to Mirsen. Chang Gu Chuan Table and DSM 4 R were used for intelligence examinations. RESULTS: In the 100 patients with LA, 23 displayed normal intelligence and 77 had intelligence impairment, among whom 20 were mild cases, 34 moderate and 23 dementia. Intelligence impairment was relative to the time and degree of LA. There was 83% intelligence impairment in LA patients with multiple cerebral infarction. The clinical features of intelligence impairment of patients with LA were emotional incontinence, urinary and fecal incontinence and gait abnormality. CONCLUSION: Patients with LA suffered from dementia and stroke more frequently than the normal population. Computed tomographic scanning findings of LA can be used to assess the development and prognosis of patients with LA.