血管性痴呆患者颅脑CT及经颅多普勒改变的定量研究

Quantitative investigation of patients with vascular dementia by CT and transcranial Dopple

目的:探讨血管性痴呆(vasculardementia,VD)患者颅脑CT和经颅多普勒改变,促进对于VD临床特点的认识。方法:对同期同一医院收集的30例VD患者、30例无明显认知功能障碍的脑梗死患者通过颅脑CT检查了解梗死病灶和脑萎缩值情况,通过经颅多普勒检查了解脑血供情况。结果:①VD组患者多发性脑梗死病例数显著多于脑梗死对照组(χ2=4.63,P<0.05)。②VD组患者脑梗死灶体积(26.3±37.8)cm3明显高于脑梗死组(7.8±15.5)cm3(t=2.49,P=0.016)。VD组三脑室宽度犤(0.84±0.14)cm犦和哈氏犤(5.76±0.71)cm犦明显高于脑梗死组犤(0.62±0.15),(5.19±0.63)cm,t=3.75,P=0.001;t=3.35,P=0.002犦。③VD组患者各脑血管的阻力指数均大于脑梗死组(t=2.07～3.09,P<0.05～0.01)。结论:VD患者有明显颅脑CT及经颅多普勒改变,普遍存在脑萎缩,存在广泛的脑血管弹性减退。

AIM:To investigate the changes of crania l CT and tran sc ranial Dopple in patients with vascular dementia(VD)and to master the clinical features o f VD.METHODS:Thirty VD patients,20males and 10fe males with a n average age of 68.2years,and 30cerebral inf arction patients without ob vious co g-nitive deficits,20males and 10fema les with the average age of 67.4years,who came from the same hospital in the same period,were enrolled in the study.CT scan and transcranial Dopp le were conducted to determine foca l cerebral lesions,cerebral atrophy and cerebral blood fluid respective ly.RES ULTS:①The patients with multiple infarcti ons were more frequently seen in VD patients than in cerebral i nfarction patients without obvious cognitive deficit s.②The focal volume of cerebral infarct ion in VD patients was(26.3±37 .8)cm 3 ,significantly higher than that of c erebral infarction patients[(7.8 ±15.5)cm 3 ,t=2.49,P=0.016].The widths of third brain ventricle and Ha w ere(0.84±0.14)cm and(5.76±0.71)cm respectively in VD group ,significantly higher than in cerebral infarction group[(0.62±0.15) ,(5.19±0.63)cm,t=3.75,P=0.001;3.35,P=0.002 ].③Re-sistent indexes of the patients with VD were bigger than those of the patie nts with cerebral infarction(t=2.07-3.09,P<0.05-0.01 ).