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背景:皮质下动脉硬化性脑病(subcorticalarterioseleroticencephalopathy,SAE)临床以高血压、脑卒中和慢性进行性痴呆为主要表现,对其确切发病机制和早期评估普遍重视不足。目的:了解老年人SAE的智能及神经心理障碍与CT分型之间的关系,探讨对SAE的评估价值。设计:以患者为研究对象,病例分析。单位:一所军区总医院的内科。对象:1999-01/2002-12解放军广州军区广州总医院共收治老年SAE患者68例,其中男65例,女3例;年龄64～93岁,平均(75.8±8.1)岁。方法:以头颅CT扫描观察脑室周围低密度灶并按GOTO方法分型。测定智能障碍水平并进行神经心理测定,进行相关分析。主要观察指标:68例患者智能障碍水平,神经心理测定结果,头颅CT表现,头颅CT分型与智能障碍评分和神经心理得分的相关关系。结果:68例中91%(62/68)的患者有不同程度的智能障碍;100%可诊断为血管性痴呆;头颅CT显示100%的患者有脑室周围低密度灶,GO-TO分型Ⅰ型22例,Ⅱ型32例,Ⅲ型14例;头颅CT分型与智能障碍评分呈负相关,与神经心理得分呈正相关,相关系数分别为-0.83和0.75(P均<0.01)。结论:老年人SAE患者的头颅CT的GOTO分型分型与智能障碍和神经心理障碍有关。
BACKGROUND: Subcortical arteriosclerotic encephalopathy (SAE) is clinically characterized by hypertension, stroke and chronic dementia. The exact pathogenesis and early assessment of SAE are generally inadequate. Objective: To understand the relationship between the intelligence and neuropsychological disorders in elderly patients with CT classification and to evaluate the value of SAE. Design: The patient as the research object, case analysis. Unit: a Military General Hospital of Medicine. PARTICIPANTS: A total of 68 elderly SAE patients were enrolled in the Guangzhou General Hospital of PLA Guangzhou Military Command from January 1999 to December 2002, including 65 males and 3 females, aged 64-93 years with an average of (75.8 ± 8.1) years. Methods: CT scans were used to observe the low density lesions around the ventricle and classified according to the GOTO method. Determine the level of mental retardation and neuropsychological testing, correlation analysis. MAIN OUTCOME MEASURES: The correlations of the levels of intelligence disorders, neuropsychological test results, head CT findings, head CT typing, intelligence impairment scores and neuropsychological scores in 68 patients. Results: Among the 68 patients, 91% (62/68) had some degree of mental retardation; 100% were diagnosed as vascular dementia; CT showed 100% 22 cases of type Ⅱ, 32 cases of type Ⅱ and 14 cases of type Ⅲ. CT scoring of head was negatively correlated with score of mental retardation, and positively correlated with neuropsychological score. The correlation coefficients were -0.83 and 0.75 respectively (all P <0.01). Conclusion: The GOTO classification of head CT in elderly patients with SAE is related to mental retardation and mental retardation.