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目的探讨50岁以下成年高血压患者脑白质微细结构损伤。方法应用磁共振(MRI)弥散张量成像(DTI)技术对45例高血压患者(高血压组)及45例年龄性别相匹配的对照组分别行常规MRI及DTI检查,测量其半卵圆中心、大脑脚、放射冠、胼胝体膝部、压部、体部、内囊前、后肢、额叶、顶叶、颞叶及枕叶脑白质部分各向异性分数(FA)。结果高血压组患者双侧大脑脚及额叶的FA值均低于对照组,差异均有统计学意义(P<0.001)。高血压组大脑脚左右两侧FA值与收缩压呈负相关(r=-0.625,r=-0.665,P<0.001),额叶的左右两侧FA值亦与收缩压呈负相关(r=-0.417,r=-0.495,P<0.05),与舒张压无相关关系;高血压组其他脑区白质FA值与收缩压及舒张压均无相关关系(P>0.05)。结论 50岁以下成年高血压患者中已经存在脑白质细微结构损伤,提示应尽早对该人群的血压进行合理控制。
Objective To investigate the ultrastructural damage of white matter in adults under 50 years of age. Methods Fifty-five hypertensive patients (hypertension group) and 45 age-matched controls were examined by conventional MRI and DTI with diffusion tensor imaging (DTI) technique. The semi-oval center , Coronal, coronal, coronal, corpus callosum, pressure, body, anterior chamber, hind limb, frontal lobe, parietal lobe, temporal lobe and occipital lobe. Results The FA values of bilateral cerebral peduncle and frontal lobe in patients with hypertension were significantly lower than those in control group (P <0.001). There was a negative correlation between FA value and systolic blood pressure (r = -0.625, r = -0.665, P <0.001) in the left and right cerebral peduncle of hypertension group. FA values in the left and right frontal lobe were also negatively correlated with systolic blood pressure (r = -0.417, r = -0.495, P <0.05). There was no correlation between diastolic blood pressure and FA in hypertensive group. There was no correlation between FA value and systolic and diastolic blood pressure in hypertensive group (P> 0.05). Conclusion The structural damage of white matter of the white matter existed in adult hypertensive patients under 50 years old, suggesting that the blood pressure of this population should be controlled as early as possible.