目的：探讨慢性心衰患者脑灰质结构存在异常的区域。方法用基于体素的形态学方法（VBM ），对比分析21例慢性心衰患者和21例年龄、性别、受教育程度相匹配的正常对照者大脑灰质体积的存在差异的脑区。结果慢性心衰患者与正常对照者相比大脑灰质总体积存在明显异常，灰质结构存在异常的区域主要位于双侧眶额叶、前扣带回、丘脑以及小脑（ P ＜0．05，FDR校正）。结论慢性心衰患者双侧眶额叶、前扣带回、丘脑以及小脑的结构异常可能是容易并发抑郁、焦虑以及认知功能损害等疾病的神经基础所在。%Objective To investigate brain structural changes in patients with chronic heart failure .Methods Twenty-one patients with chronic heart failure and 21 normal controls (matched with age ,sex and extent of education) underwent structural MRI scan .The imaging data were analyzed using voxel-based morphometry method .Results Compared to nor-mal controls ,the patients with chronic heart failure showed significant decrease in total brain gray matter volume and re-gional gray matter mainly in the bilateral orbitofrontal cortex ,anterior cingulate cortex ,thalamus and cerebellum .( P<0 .05 ,FDR corrected) .Conclusion The patients with chronic heart failure may have brain structural abnormalities in bi-lateral orbitofrontal cortex ,anterior cingulate cortex ,thalamus and cerebellum ,which might play a critical role in patho-physiology of depression ,anxiety or cognitive impairment following chronic heart failure .
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