单纯脑白质疏松症与宾斯旺格病的脑血流变化对比研究

Comparative study on the cerebral hemodynamics changes between Leukoaraiosis and Binswanger disease

目的:观察单纯脑白质疏松症(leukoaraiosis,LA)与宾斯旺格病(binswangerdisease,BD)脑血流动力学及局部脑血流的变化,探讨LA和BD是否存在经颅多普勒(TCD)与单光子发射计算机断层(SPECT)异常改变程度上的不同和异常部位的不同。方法:对49例LA和18例BD和30例正常老年人均行TCD检查,观察脑血流动力学改变情况,并对其中10例LA和9例BD患者行SPECT检查,观察局部脑血流灌注(regionalcerebralbloodflow,rCBF)情况。结果:①单纯LA组与BD组患者颈内动脉系统平均血流速度均显著低于正常对照组(t=2.98～5.64,P<0.01),BD组患者颈内动脉系统平均血流速度又显著低于单纯LA组(t=2.67～5.40,P<0.01),BD组椎基底动脉系统平均血液速度显著低于单纯LA组及正常对照组(t=2.69～4.80,P<0.01)。②SPECT检查发现所有BD患者均存在白质rCBF减少,而单纯LA组患者只有5例存在rCBF减少,其减少程度亦较BD轻。结论:①BD患者的脑血流低灌注程度较单纯LA重。②单纯LA患者脑血流低灌注主要表现在颈内动脉系统,而BD患者颈内动脉系统和椎基底动脉系统均存在严重的脑血流低灌注。

AIM:To observe the changes of cerebral hemodynamics and regional cerebral bloo d flow (rCBF) in Leukoaraiosis (LA) patients and Binswanger disease (BD) patient s and to explore the difference in abnormal degree and abnormal area between LA and BD with transcranial Doppler (TCD) and single photon emission computed tomog raphy (SPECT). METHODS:Forty-nine LA patients, 18 BD patients and 30 healthy elders were exa mined by TCD to observe the cerebral hemodynamics changes, among which 10 LA pat ients and 9 BD patients were examined by SPECT to observe the changes of rCBF. RESULTS: ①In internal carotid artery system, the mean velocity of LA patients and BD patients was lower than that of the healthy controls (t=2.98-5.64,P< 0. 01), whereas that of BD patients was significantly lower than that of LA patient s (t=2.67-5.40,P< 0.01). In vertebral-basilar artery system, the mean velocity of BD patients was lower than that of LA patient and the healthy controls separ ately (t=2.69-4.80,P< 0.01).②SPECT showed rCBF decreased in every BD patient, while only in 5 LA patients which was slighter as compared with BD patients.