spect对缺血性脑血管病远隔缺血预适应的疗效评价研究.doc

临床和实验医学杂志 2017,21(16),2091-2095 DOI:.1671-
SPECT对缺血性脑血管病远隔缺血预适应的疗效评价研究
关乐卢洁候亚琴张海琴吉训明梁志刚
首都医科大学宣武医院核医学科首都医科大学宣武医院神经外科
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摘    要:
目的探讨单光子发射计算机断层(SPECT) 显像对缺血性脑血管病(ICVD) 患者在远隔缺血预适应疗效评价中的应用价值。方法 50例单侧颅内外动脉重度狭窄或闭塞的缺血性脑血管病患者, 远隔缺血预适应(RIPC) 治疗前后分别行SPECT脑血流灌注和脑葡萄糖代谢显像, 分析RIPC治疗前后脑血流灌注及脑葡萄糖代谢显像病灶数量、脑血流量及脑代谢率的差异。结果 50例ICVD患者RIPC治疗后脑血流灌注异常病灶数量减少, 47例(%) 血流灌注有不同程度增高;3例(%) 脑血流灌注增高患者有不同程度减低。50例ICVD患者RIPC治疗后脑葡萄糖代谢异常病灶数量增加, 40例代谢减低的患者有34例(%) 不同程度代谢增高;10例代谢增高的患者有6例(%) 不同程度代谢减低。50例ICVD患者RIPC治疗前后SPECT显像比较, 患侧额、顶、颞、枕叶、基底节和丘脑的血流灌注显著增高(P<) ;额、颞、枕叶、基底节和丘脑的葡萄糖代谢显著增高(P<) , 顶叶葡萄糖代谢增高无显著性差异(P>) 。结论 SPECT脑血流灌注及脑葡萄糖代谢显像对评价RIPC治疗ICVD的疗效有重要价值。
关键词:
缺血性脑血管病; 远隔缺血预适应; 单光子发射断层成像;
作者简介:卢洁, E-mail:imaginglu@
收稿日期:2017-04-05
基金:十三五国家重点研发项目资助(编号:2016YFC)
Study on the evaluation of efficacy of remote ischemic preconditioning in patients with ischemic cerebrovascular disease by using SPECT
GUAN Le LU Jie HOU Ya-qin
Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University;
Abstract:
Objective To explore the efficacy of remote ischemic preconditioning ( RIPC) in patients with ischemic cerebrovascular disease by using SPECT. Methods 50 cases of ischemic cerebrovascular disease with unilateral intracranial or extracranial artery stenosis or occlusion were performed SPECT for cerebral blood flow perfusion and cerebral glucose metabolism imaging before and after RIPC. The number of lesions, semi-quantitative analysis and the difference between RIPC before and after cerebral blood flow and cerebral metabolism were qualitatively analyzed. Results After RIPC the cerebral blood flow perfusion showed the decrease in number of lesions, and the cerebral blood flow had been increased in 47 ( 94. 0%) patients with reduced cerebral blood flow perfusion before RIPC; the cerebral blood flow was decreased in 3 ( 6. 0%) patients wi