CAJ | 학술논문

目的：通过观察皮质下缺血性血管病（SIVD）患者不同脑区局部脑血管反应性（CVR）的变化及认知功能的损害，探讨 SIVD 局部 CVR 的改变在认知功能损害中的作用。方法：采用动脉自旋标记（ASL）磁共振灌注技术定量测定 SIVD 患者与对照组吸入5％ CO2前后额叶、颞叶、顶叶、枕叶皮质和白质局部血流量（rCBF），CVR 采用前后2次各兴趣区 rCBF 的增加率表示。结果：（1） SIVD 组额叶皮质及白质、颞叶白质、枕叶白质的 CVR 比对照组显著降低（P ＜0．05）。（2） SIVD 组有认知功能损害患者和无认知功能损害患者相比额叶皮质、额叶白质 CVR 下降明显（P ＜0．01）。结论：SIVD 患者存在广泛的脑血管自动调节功能受损，并且额叶皮质、白质的 CVR 下降与认知功能损害有关。
목적：통과관찰피질하결혈성혈관병（SIVD）환자불동뇌구국부뇌혈관반응성（CVR）적변화급인지공능적손해，탐토 SIVD 국부 CVR 적개변재인지공능손해중적작용。방법：채용동맥자선표기（ASL）자공진관주기술정량측정 SIVD 환자여대조조흡입5％ CO2전후액협、섭협、정협、침협피질화백질국부혈류량（rCBF），CVR 채용전후2차각흥취구 rCBF 적증가솔표시。결과：（1） SIVD 조액협피질급백질、섭협백질、침협백질적 CVR 비대조조현저강저（P ＜0．05）。（2） SIVD 조유인지공능손해환자화무인지공능손해환자상비액협피질、액협백질 CVR 하강명현（P ＜0．01）。결론：SIVD 환자존재엄범적뇌혈관자동조절공능수손，병차액협피질、백질적 CVR 하강여인지공능손해유관。
Objective To assess regional cerebrovascular reactivity (CVR) and cognition impairment of subcortical ischemic vascular disease (SIVD). To show whether CVR affects cognitive impairment of SIVD patients. Methods Arterial spin-labeling (ASL) by MR image was applied in measuring regional cerebral blood flow (rCBF) of frontal lobe, temporal lobe, parietal lobe, occipital lobes after 5% CO2 inhalation, and the CVR was demonstrated by increase rate of rCBF in all the subject areas. Results (1)The patients with SIVD had reduced CVR in cortex of frontal lobes, white matter of frontal lobes, temporal lobes and occipital lobes(P < 0.05). (2) CVR in the SIVD patients with cognitive impairment decreased in frontal cortex and white matter when compared with the patients without cognitive impairment(P < 0.01). Conclusion These results showed that CVR decreased significantly in cortical gray matter and white matter in elderly patients with SIVD. Also the reduction of CVR in the frontal cortex and white matter was associated with cognitive impairment.