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目的:分析不同程度和部位脑白质疏松症(leukoaraiosis，LA)患者的步态和平衡障碍的特点以及跌倒风险。方法:选取LA患者78例(LA组)和健康对照组(NC组)30例。根据Fazekas分级量表将LA组分为不同程度亚组(LA1组、LA2组、LA3组)并对脑室周围白质高信号(PVH)和深部白质高信号(DWMH)独立评分。采用Tinetti平衡与步态量表对所有被试进行步态测试、平衡测试以及跌倒风险评价，并分析步态测试结果和平衡测试结果与PVH评分和DWMH评分的相关性。结果:LA组与NC组在步态测试[(11.47±0.51)分，(10.18±1.29)分]、平衡测试[(15.63±0.49)分，(13.96±1.58)分]以及跌倒风险[(27.10±0.76)分，(24.15±2.73)分]差异均有统计学意义(n t＝5.310，5.667，5.799，均n P0.05)，NC组和LA2组、LA3组在步态测试、平衡测试及得跌倒风险差异有统计学意义(n t＝1.110，1.562，1.336；2.592，3.342，2.985；均n P<0.01)，LA1组[(11.19±0.85)分，(15.38±0.75)分，(26.58±1.47)分]和LA2组[(10.36±0.82)分，(14.07±1.09)分，(24.43±1.64)分]、LA3组[(8.88±0.99)分，(12.23±1.08)分，(21.21±1.93)分]在步态测试、平衡测试及跌倒风险差异有统计学意义(n t＝0.835，1.313，1.039；2.317，3.093，2.756；均n P<0.01)，LA2组和LA3组比较在步态测试、平衡测试及跌倒风险差异有统计学意义(n t＝1.482，1.780，1.639，均n P<0.01)；相关分析结果显示步态测试与PVH和DWMH评分呈负相关(n r＝－0.810，n P<0.01；n r＝－0.452，n P<0.01)；平衡测试与PVH和DWMH评分呈负相关(n r＝－0.502，n P<0.01；n r＝－0.836，n P<0.01)。n 结论:中重度LA患者存在步态障碍和平衡障碍，且随着LA病变程度增加，步态和平衡功能的损害明显增加，跌倒风险亦明显增高。LA患者不同部位脑白质高信号评分与步态障碍和平衡障碍相关性不同，步态障碍与PVH评分相关性更加明显，而平衡障碍与DWMH评分相关性更加明显。“,”Objective:To analyze the gait and balance disorder and fall risk in patients with leukoaraiosis (LA) in different degrees and locations.Methods:Seventy-eight patients with LA (LA group) and thirty healthy controls (NC group) were selected.According to Fazekas grading scale, the LA group were subgroups of different degrees(LA1, LA2, LA3)and evaluated independent scores for periventricular white matter hypersignal (PVH) and deep white matter hypersignal (DWMH). All subjects were tested by Tinetti scale, and the gait test, balance test and fall risk assessment were carried out, and the correlation between gait test results and balance test results and PVH and DWMH scores were analyzed.Results:There were significant differences in gait test((11.47±0.51), (10.18±1.29)), balance test((15.63±0.49), (13.96±1.58)) and fall risk((27.10±0.76), (24.15±2.73)) between LA group and NC group (n t=5.310, 5.667, 5.799, all n P0.05). There were significant differences in gait test, balance test and fall risk between NC group and LA2 group and LA3 group (n t=1.110, 1.562, 1.336; 2.592, 3.342, 2.985; all n P<0.01). There were significant differences in gait test, balance test and fall risk between LA1 group((11.19±0.85), (15.38±0.75), (26.58±1.47)) and LA2 group((10.36±0.82), (14.07±1.09), (24.43±1.64)) and LA3 group((8.88±0.99), (12.23±1.08), (21.21±1.93)) (n t=0.835, 1.313, 1.039; 2.317, 3.093, 2.756; all n P<0.01). There were significant differences in gait test, balance test and fall risk between LA2 group and LA3 group (n t=1.482, 1.780, 1.639, all n P<0.01). The analysis showed that the gait test was negatively correlated with the PVH and DWMH scores (n r=-0.810, n P<0.01;n r=-0.452, n P<0.01). The balance test was negatively correlated with the PVH and DWMH scores (n r=-0.502, n P<0.01;n r=-0.836, n P<0.01).n Conclusions:There are gait disorder and balance disorder in patients with moderate and severe LA.With the increase of the degree of LA , the damage of gait and balance function is significantly increased, and the risk of fall is also significantly increased.The gait disorder and the balance disorder of LA patients has different correlation with the high-signal score of the white matter in different parts.The correlation between gait disorder and PVH score is more obvious, and the correlation between balance disorder and DWMH score is more obvious.