多发白质微梗死与脑白质疏松的相关性

The Study of the Relationship between Multiple Micro-leuko-infarction and Leukoaraiosis

目的探讨白质微梗死与脑白质疏松（LA）有无相关性及LA的发病机制。方法收集2012年1月-2015年7月因头昏、头晕等入院的急性白质微梗死收住院的124例患者及查体中心门诊健康体检者33例为研究对象,研究对象知情并且同意1年以后复查颅脑磁共振。根据Fazekas量表将入组患者按照LA的严重程度进行分级分组（LA0级组、LA1级组、LA2级组、LA3级组）。以患者入组时作为时间基点,1年后随诊复查颅脑MRI,分别在基点及1年后对每组患者的颅脑MRI进行白质高信号评分。结果 LA0级组与对照组比较,1年后白质高信号评分明显增加（P〈0.01）。LA0-LA3级组患者在基点时和1年后的白质高信号评分差值相邻两组比较,有显著性意义（P值均〈0.05）。结论有白质新发微梗死的LA0组比正常对照组白质病变进展明显快,白质病变越严重,进展越快,推测多发白质微梗死促进LA的发生和进展。

Objective To investigate the relationship between micro-leuko-infarction and leukaraiosis,and to investigate the pathogenesis of leukoaraiosis. Methods One hundred and twenty- four patients with acute micro-leuko-infarction and 33 healthy individuals who voluntarily received a health examination including brain MRI scans at the health examination center from January 2012 to July 2015 were followed up for one year. According to the grading of severity of leukoaraiosis（ LA） using the Fazekas scale,the patients were classified as group LA0,LA1,LA2,LA3. The changes of LA were rescaled one year later by brain MRI-FLAIR. The score difference of LA from baseline to one year later were compared by SPSS 17. 0 statistical software. Results There was significant difference of the white matter hyperintensity scores from baseline to one year later between control group and group LA0. There was significant difference of the increased scores of white matter change between the baseline and 1 years later between neighboring LA group（ P〈0. 05）. Conclusion The micro-leuko-infarction were found to promote the white matter change more rapidly than the control group,the more severe the micro-leuko-infarction is,the more rapid the LA developes.