多发梗塞性痴呆与多发性脑梗塞脑容积线性指标的对照研究

Comparison of cerebral atrophy indexes between cerebral infarction and multiple infarction dementia

目的 探讨脑容积在高级认知功能代偿中的作用 ,以及老年脑的脑容积改变与多发性梗塞性痴呆 (MID)的关系。方法 采用病例对照研究的方法 ,2 1例MID匹配以年龄相当的 6 3例多发性脑梗塞 (MI)。CT下测量平均脑沟宽度 ,平均侧裂宽度 ,纵裂宽度 ,3脑室宽度 ,额角指数 ,尾状核指数 ,脑室指数 ,Evans指数 ,及侧脑室指数。结果 MID组病灶多累及左侧半球、丘脑 ,且病灶容积大于MI组 ;除纵裂宽度、3脑室宽度外各指标亦均大于MI组 (P <0 0 5 ;P <0 0 1)。结论 在剔除年龄混杂因素后 ,老年脑脑容积的下降可能是MID发生痴呆的又一重要因素。说明脑容积和脑结构完整性在高级认知功能代偿中起关键作用。

Objective To study the relationship between the change of brain volume of aging and multiple infarction dementia (MID), and the compensatory role of the high cognitive function of aging brain. Methods A 1∶3 case-matching approach was employed,and 21 cases with MID were matched with 63 cases of multiple cerebral infarction (MI) in comparable age. Indicators included average width of gyrus, average width of lateral fissures, width of vertical fissure, width of 3rd ventricle, index of frontal angel, index of caudal nucleus, index of ventricle, Evans' index and index of lateral ventricle.Results The lesions of MID often involved left hemisphere and thalamus and were larger volume than of MI (P<0.05, or P<0.01). Apart from widths of the vertical fissure and the 3rd ventricle, all other indicators of MID were larger than that of MI (P<0.05, or P<0.01). Conclusion In addition to age, the decrease in brain volume of the aged may play an important role in the occurrence of MID. The result suggests that normal volume and integrality of brain structure play a compensatory role in high-level cognitive functions of aging brain.