目 的 对 H I V相关痴呆 ( H I V associated dementia,HAD)脑萎缩患者进 行动态追踪观察，探索脑萎缩的演变与 HIV相关痴呆进展的相关性。方法 对进行 1至9个月动态观察的16例HIV相关痴呆的 脑萎缩MRI资料进行回顾性分析，统计分 析HIV相关痴呆的痴呆进展与脑萎缩的相 关性。结果 16例HIV相关痴呆病例随着脑 萎缩的进展，出现国际人类免疫缺陷病 毒相关性痴呆量表(International HIVAssociated Dementia Scale，IHDS)评分 的降低。MRI主要表现为进行性的脑萎缩 和脑白质病变，表现为额叶皮层的进行性 变薄，基底节灰质核团体积变小，脑沟及 脑室系统进行性扩张，皮层下及半卵圆中 心脑白质斑片影范围进行性扩大。全部 病例脑萎缩的进展与IHDS评分为负相关 (P<0.05)。结论 脑萎缩的进展与IHDS评 分为负相关，本研究对临床诊断HAD和判 断预后有积极意义。

Objective To explore the correlation between the development of brain atrophy and the progression of HAD by dynamic tracing of 16 patients with HAD. Methods The MRI data of 16 patients with HAD were analyzed retrospectively, and the correlation between dementia progression of HAD and brain atrophy was analyzed retrospectively from 1 to 9 months. Results A total of 16 cases of HAD with the development of brain atrophy, accompanied by the IHDS score decreased. The main manifestations of MRI were progressive brain atrophy and white matter lesions. The results showed that the frontal cortex became thinner, the volume of basal ganglia became smaller, and the expansion of the cerebral sulci and ventricles system. The results of statistical analysis showed that there was a negative correlation between brain atrophy and IHDS score (P<0.05). Conclusion The development of brain atrophy was negatively correlated with IHDS score. This study has positive significance for clinical diagnosis of HAD and prognosis.