目的　探讨皮层下动脉硬化性脑病（ＳＡＥ）的临床诊断标准。方法　对８４例ＳＡＥ患者的临床、影像学表现进行跟踪观察。结果　临床以慢性进行性智能减退为主要表现，中晚期呈皮层下痴呆，多伴有高血压、视网膜动脉硬化和局灶性神经系统体征。ＣＴ与ＭＲＩ示脑室周围白质疏松。结论　对ＳＡＥ的临床诊断应强调存在智能障碍，不宜过分强调痴呆。并提出ＳＡＥ的诊断应该是动态的，对不典型病例应进行跟踪观察。 Objective To investigate the clinical diagnostic criteria of subcortical arteriosclerotic encephalopathy (SAE). Methods The clinical and radiographic findings of 84 patients with SAE were followed up. Results The clinical manifestations of chronic progressive hypothyroidism as the main performance of advanced subcortical dementia, often accompanied by hypertension, retinal arteriosclerosis and focal nervous system signs. CT and MRI showed ventricles around white matter loose. Conclusions The clinical diagnosis of SAE should emphasize the existence of mental retardation, it is inappropriate to over-emphasize dementia. And proposed SAE diagnosis should be dynamic, atypical cases should be followed up.