目的：脑小血管病（CSVD）是导致认知功能障碍的常见病因。本研究旨在采用静息态功能磁共振技术探讨CSVD伴轻度认知功能障碍患者海马功能连接变化模式及其可能的机制。方法：本研究选取神经内科就诊的CSVD认知正常者20例,SVD伴轻度认知障碍患者20例以及正常对照组22例。通过静息态功能磁共振技术分别构建双侧海马全脑功能连接。采用基于体素的线性回归方法探讨海马功能连接与认知的相关性。最后利用偏相关分析CSVD影像学特征、海马功能连接与认知功能之间的相互关系。结果： CSVD伴轻度认知障碍患者存在双侧海马-左侧额下回、左侧海马-左侧枕中回功能连接显著升高,且双侧海马-左侧额下回功能连接与记忆功能呈显著负相关。此外,CSVD影像学特征与认知相关性分析提示,CSVD伴轻度认知障碍组白质病变总体积或者室周白质病变总体积与信息处理速度功能呈显著负相关。结论：CSVD患者通过静息态海马功能连接显著升高进行功能代偿,为CSVD引起认知障碍的神经网络机制提供依据,可能为疾病早期识别和干预提供可靠的影像学指标。

Objective Cerebral small vessel disease (CSVD) is a common cause of cognitivedysfunction. The purpose of this study was to explore the changes of hippocampal functional connectivity in CSVD patients with mild cognitive impairment and its possible mechanism by resting-state functional magnetic resonance imaging. Methods Twenty CSVD patients with normal cognition, 20 CSVD patients with mild cognitive impairment and 22 healthy controls were selected. The functional connectivity of bilateral hippocampus was constructed by resting state functional magnetic resonance imaging. A voxel-based linear regression method was used to explore the correlation between hippocampal functional connectivity and cognition. Finally, correlation between CSVD imaging features, hippocampal functional connectivity and cognitive function was analyzed by partial correlation analysis. Results We found that the functional connectivity of bilateral hippocampus-left inferior frontal gyrus and left hippocampus-left middle occipital gyrus was significantly elevated in SVD patients with mild cognitive impairment and the functional connectivity of bilateral hippocampus-left inferior frontal gyrus was negatively correlated with memory function. In addition, the partial correlation analysis suggested that the total volume of white matter lesions or periventricular white matter lesions in patients CSVD with mild cognitive impairment was negatively correlated with information processing speed. Conclusion SVD patients compensate by significantly elevated resting hippocampal functional connectivity, which provides a basis for understanding the neural network mechanism of cognitive impairment caused by SVD, and may provide reliable imaging indicators for early identification and intervention.