为了研究血管性认知障碍（vascular cognitive impairment, VCI）与颅内外大动脉狭窄、脑白质病变以及脑萎缩之间的关系。通过连续纳入105例VCI的患者为研究对象，分为轻度组（n＝77）和重度组（n＝28），同时选取认知正常的患者作为对照组（n＝71）；比较3组间脑血管病危险因素、脑白质病变、缺血性脑梗死、脑萎缩的差异，分析颅内外大血管狭窄程度和VCI之间的相关性。结果表明：3组间缺血性卒中病史和腔隙≥2个的比例差异有统计学意义（P<0.001）。3组间脑白质高信号、脑室旁白质、深部白质Fazekas评分、全脑皮质萎缩GCA分级的差异均有统计学意义（P<0.001）。在多元有序logistic回归分析模型中，发现颈内动脉C1段、颈内C2~C7段、大脑中动脉狭窄程度是VCI严重程度的主要影响因素。颈内动脉C1段、颈内C2~C7段狭窄程度与VCI患者严重程度存在低等程度正相关，而大脑中动脉狭窄程度、脑白质病变、脑萎缩分级与VCI患者严重程度存在中等程度正相关。可见随着心血管危险因素、缺血性卒中病史及颈内动脉、大脑中动脉狭窄程度的增加，受试者发生VCI的风险显著增加。表明颅内外大动脉病变情况可作为VCI的检测指标之一，存在一定的可行治疗方向。

In order to study the relationship between VCI (vascular cognitive impairment) and intracranial and extracranial large artery stenosis, cerebral white matter lesions and brain atrophy. By consecutively enrolling 105 patients with VCI, divided into mild group (n = 77) and severe group (n = 28), and at the same time selecting patients with normal cognition as the control group (n = 71). comparing the differences in cerebrovascular disease risk factors, cerebral white matter lesions, ischemic cerebral infarction, and cerebral atrophy among the 3 groups, and analysing the correlation between the degree of stenosis of the intracranial and extracranial large arteries and VCI. The results show that the differences in the history of ischaemic stroke and the proportion of ≥ 2 lacunae were statistically significant among the 3 groups (P < 0.001). The differences in cerebral white matter high signal, paraventricular white matter, deep white matter Fazekas score, and whole-brain cortical atrophy GCA grading were statistically significant among the 3 groups(P < 0.001). In the multivariate ordered logistic regression analysis model, it was found that internal carotid artery segment C1, internal carotid segment C2 ~ C7, and the degree of middle cerebral artery stenosis are the main influencing factors for the severity of VCI. The degree of stenosis of internal carotid artery C1 segment and internal carotid C2 ~ C7 segment is positively correlated with the severity of VCI patients to a low degree, whereas the degree of stenosis of the middle cerebral artery, cerebral white matter lesions, and cerebral atrophy grading are positively correlated with the severity of VCI patients to a moderate degree. It is evident that with increasing cardiovascular risk factors, history of ischaemic stroke and degree of stenosis of the internal carotid and middle cerebral arteries, the risk of VCI in the subjects increased significantly. It suggests that the condition of intracranial and extracranial large arterial lesions can be used as one of the indicators for the detection of VCI, and that there are certain feasible therapeutic directions.