中文摘要：

目的利用磁共振功能成像（fMRI）技术，研究无心脑肾并发症以及认知障碍的中重度高血压患者是否存在认知相关的脑功能异常。方法50名受试者参加试验。中重度原发性高血压患者25例，正常对照25名，按性别、年龄及文化程度匹配。fMRI刺激模式为Block Design，刺激材料通过听觉呈现。实验1任务要求受试者仔细听无意义假词词组。实验2要求听真词词组，并对词性（具体词还是抽象词）做心理判断。fMRI数据处理用SPM99软件，获得基于单个像素分析的检验激活图及负激活图。结果简易智能状态检查，高血压组29．3±1．1、对照组29．6±0．5，两组分值差异无统计学意义（P=0．5223）。焦虑状态量表分值，患者组（47±5）高于对照组（42±5）（P=0．0356）。fMRI实验1：患者组与对照组相比，激活与负激活脑区部位基本相同，但是患者组有关脑区的活动强度强于正常对照组。fMRI实验2两组受试者激活与负激活脑区也相同，激活脑区包括两侧颞上回、额下回脑区；左侧角回；两侧额上回、运动前区；两侧辅助运动区及小脑半球等。负激活脑区包括前额叶中内侧、后带回后部／楔前叶、两侧顶下小叶及枕叶区域等。但患者组激活的强度与范围均大于对照组。结论无心脑肾并发症以及行为认知障碍的中重度高血压患者，可能已经存在某些脑功能异常，fMRI技术有可能早期检测到这些改变。

英文摘要：

Objective To explore whether the hypertension patients with no clinical cognitive impairment manifestations have certain brain dysfunctions. Methods Twenty-five moderately to severely hypertensive patients, males and females, aged 63.0 ±1.6 （60 -65）, with a disease history if5 to 10 years, and 25 sex, age, and educational level-matched healthy persons underwent tests by mini-mental status examination （MMSE） scales, state anxiety inventory （STAI-S） and trait anxiety inventory （STAI-T）, and then underwent two functional magnetic resonance imaging （fMRI） studies. In Experiment 1, the subjects were demanded to listen actively to the meaningless words （pseudowords） and in Experiment 2 the subjects listened actively to real words and make the valence （ abstract or concrete） of the words in silence. The subjects were told to listen passively the noise from the MR scanners during the resting period, which was used as the control task. The fMRI data were analyzed with statistical parametric mapping （SPM99） software. Results The MMSE score of the patient group was 29. 3 ± 1.1, not significantly different from that of the control group （29. 6 ± 0. 5, P 〉 0. 05 ）. The STAI-S score of the patient group was 47 ± 5. 3748, significantly higher than that of the control group （41.6 ± 4. 9777, P 〈 0. 05 ）. The STAI-S score of the patient group was 45 ±3, not significantly different from that of the control group （43 ±4, t = 1. 0619, P = 0. 3032）. In Experiment 1, the activated patterns and deactivated patterns were nearly similar for the patient and control groups. The activated regions included the bilateral superior temporal lobe, bilateral inferior frontal cortex and supplementary motor areas. In Experiment 2, the activated patterns were also nearly similar for these 2 groups. The regions included the bilateral superior temporal lobe, bilateral inferior frontal cortex, left angular gyms, bilateral superior frontal cortex, bilateral cerebellum, premotor areas, and supplementa