目的探讨脑内微出血(CMBs)与患者认知功能损害、腔隙性脑梗死(LI)及脑白质疏松(LA)的相关性。方法连续选取2011年7月至2012年3月首次头部MRI(T1、T2、T2-Flair)检查显示存在LI和/或LA的患者38例,进一步行头部磁敏感加权成像(SWI)检查,按是否存在CMBs病灶分为CMBs组和非CMBs组。记录并分析与CMBs有关的常见脑血管病危险因素;检测血脂;用MMSE及Mo CA量表评价认知功能;分析CMBs与LA及LI的相关性。结果 CMBs组13例,年龄(73.8±7.9)岁;11例(84.6%)有高血压病史。非CMBs组25例,年龄(64.1±9.9)岁;13例(52.0%)有高血压病史。两组间年龄、高血压病史差异有统计学意义(P均<0.05);两组间性别、糖尿病病史、吸烟史、饮酒史、家族史及胆固醇水平等比较差异无统计学意义(P均>0.05)。Logistic回归分析表明,CMBs的存在与年龄相关(OR=1.11,P<0.05)。CMBs组共有CMBs病灶58个,包括:基底节及丘脑36个、皮质及皮质下14个、脑干3个、小脑5个。Spearman等级相关检验表明,CMBs的存在与LA分数(r=0.665,P<0.01)及LI灶数目(r=0.365,P<0.05)呈正相关,CMBs数目与LA分数(r=0.643,P<0.01)及LI病灶数目(r=0.474,P<0.01)呈正相关;Mo CA总分与LA分数存在负相关(r=-0.339,P<0.05),与CMBs数目、LI病灶数目无明显相关性。CMBs组的MMSE及Mo CA评分明显低于非CMBs组,差异均有统计学意义(P均<0.05);Mo CA总分与LA分数负相关(r=-0.339,P<0.05),与CMBs数目、LI病灶数目无相关性。结论 CMBs与患者的年龄和是否存在LI、LA相关。CMBs的存在与数目及LA评分与患者认知功能损害相关。 Objective To investigate the correlation between intracerebral hemorrhage (CMBs) and cognitive impairment, lacunar infarction (LI) and brain leukoaraiosis (LA). Methods Thirty-eight consecutive patients with LI and / or LA were examined by MRI (T1, T2, T2-Flair) from July 2011 to March 2012. Magnetic resonance weighted imaging (SWI) , According to the presence of CMBs lesions were divided into CMBs group and non-CMBs group. The risk factors of common cerebrovascular diseases related to CMBs were recorded and analyzed. The levels of blood lipids were measured. The cognitive function was assessed by MMSE and MoCA scales. The correlation between CMBs and LA and LI was analyzed. Results CMBs group of 13 patients, age (73.8 ± 7.9) years; 11 cases (84.6%) had a history of hypertension. Twenty-five non-CMBs patients (64.1 ± 9.9 years old) and 13 patients (52.0%) had a history of hypertension. There was significant difference between the two groups in the age and the history of hypertension (P <0.05). There was no significant difference in gender, history of diabetes, smoking history, drinking history, family history and cholesterol between the two groups (P> 0.05). Logistic regression analysis showed that the presence of CMBs was age-related (OR = 1.11, P <0.05). There were 58 CMBs lesions in the CMBs group, including 36 basal ganglia and thalamus, 14 cortex and cortex, 3 brainstem and 5 cerebellum. Spearman rank correlation test showed that there was a positive correlation between the presence of CMBs and LA score (r = 0.665, P <0.01) and the number of LI foci (r = 0.365, P <0.05) ) And LI (r = 0.474, P <0.01). There was a negative correlation between Mo score and LA score (r = -0.339, P <0.05). There was no significant correlation between the number of CMBs and the number of LI lesions. The scores of MMSE and Mo CA in CMBs group were significantly lower than those in non-CMBs group (P <0.05), while the Mo scores were negatively correlated with LA scores (r = -0.339, P <0.05) Number, LI no correlation between the number of lesions. Conclusions CMBs are associated with the patient’s age and the presence or absence of LI and LA. The presence and number of CMBs and LA scores were associated with impaired cognitive function in patients.