远隔缺血预适应对脑缺血疗效的SPECT评价

doi:10.3969/j.issn.1006-7795.2013.01.002

首都医科大学学报 ›› 2013, Vol. 34 ›› Issue (1): 6-10.doi: 10.3969/j.issn.1006-7795.2013.01.002

远隔缺血预适应对脑缺血疗效的SPECT评价

何洁^1,2, 吉训明³, 李思颉⁴, 李如娟⁵

1. 首都医科大学宣武医院核医学科, 北京 100053;
2. 首都医科大学石景山教学医院, 北京市石景山医院核医学科, 北京 100043;
3. 首都医科大学宣武医院神经外科, 北京 100053;
4. 首都医科大学宣武医院脑血管病研究室, 北京 100053;
5. 河北省邢台市巨鹿县医院神经内科, 河北邢台 055250

收稿日期:2012-12-06 出版日期:2013-02-21 发布日期:2013-02-25
通讯作者: 吉训明 E-mail:robertjixm@hotmail.com
基金资助:
国家自然科学基金(30870854)资助项目

Effect of remote ischemic preconditioning in patients with ischemic stroke evaluated using single photon emission computed tomography imaging

HE Jie^1,2, JI Xunming³, LI Sijie⁴, LI Rujuan⁵

1. Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Nuclear Medicine, Shijingshan Teaching Hospital, Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China;
3. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
4. Institute of Cerebrovascular Disease Research, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
5. Department of Neurology, Jvlu County Hospital, Xingtai 055250, Hebei Province, China

Received:2012-12-06 Online:2013-02-21 Published:2013-02-25
Supported by:
This study was Supported by National Natural Science Foundation of China(30870854).

摘要/Abstract

摘要：

目的通过单光子发射计算机断层成像术(single photon emission computed tomography, SPECT)观察远隔缺血预适应组与对照组中风患者治疗前后脑血流灌注变化,了解SPECT在远隔缺血预适应中的价值。方法 50例患者入选,按照治疗方法不同分成两组:远隔缺血预适应组33例,对照组17例。经颅多普勒超声检查证实患单侧颅内动脉中重度狭窄或闭塞,磁共振成像检查除外脑占位病变及脑出血性病变。对两组患者治疗前后脑血流灌注显像结果分别进行分析。结果 1)远隔缺血预适应组患者额、颞、顶、枕叶皮质,患侧与对侧相应区域放射性计数比值治疗前后比较,差异无统计学意义,基底节和丘脑治疗前后比较,差异有统计学意义(P<0.05)。2)对照组上述各部位,患侧与对侧相应区域放射性计数比值的差异均无统计学意义。结论远隔缺血预适应能改善缺血脑组织对缺血的耐受,通过SPECT检查发现经缺血预适应治疗的患者基底节和丘脑血流灌注改善明显。SPECT可为临床判断疗效提供客观的影像学依据。

关键词: 脑缺血, 远隔缺血预适应, 体层摄影术, 发射型计算机, 单光子

Abstract:

Objective To observe the changes of brain blood flow perfusion in patients with ischemic stroke in remote ischemic preconditioning group and control group before and after treatment using single photon emission computed tomography (SPECT) and to find out the value of remote ischemic preconditioning by SPECT. Methods Fifty patients seen in our hospital were selected, according to the different treatment options they were divided into two groups, 33 cases in remote ischemic preconditioning group and 17 cases in control group. The transcranial Doppler examination confirmed the presence of severe stenosis or occlusion in unilateral intracranial artery. Brain lesions and cerebral hemorrhagic lesions were excluded by magnetic resonance imaging. To analyse the result of patients with ischemic stroke in two groups, respectively, the patients underwent SPECT perfusion scan of cerebral blood flow before and after treatment.Results 1)The ratio of the impaired area to the opposite area in frontal,temporal,parietal,occipital lobe in patients of remote ischemic preconditioning group had no statistically significant difference before and after treatment (P>0.05). But in basal ganglia and thalamus, there was statistically significant difference (P<0.05). 2) The ratio of the impaired area to the opposite area in patients of control group with the above-mentioned parts had no significant difference before or after treatment (P>0.05).Conclusion Remote ischemic preconditioning can improve brain tolerance to ischemia. By SPECT, blood flow perfusion in basal ganglia and thalamus of patients were significantly improved after remote ischemic preconditioning. It is helpful to provide objective imaging evidence by SPECT.

Key words: cerebrovascular disorders, remote ischemic preconditioning, tomography, emission computed, single photon

中图分类号:

R743.31

何洁, 吉训明, 李思颉, 李如娟. 远隔缺血预适应对脑缺血疗效的SPECT评价[J]. 首都医科大学学报, 2013, 34(1): 6-10.

HE Jie, JI Xunming, LI Sijie, LI Rujuan. Effect of remote ischemic preconditioning in patients with ischemic stroke evaluated using single photon emission computed tomography imaging[J]. Journal of Capital Medical University, 2013, 34(1): 6-10.

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远隔缺血预适应对脑缺血疗效的SPECT评价

Effect of remote ischemic preconditioning in patients with ischemic stroke evaluated using single photon emission computed tomography imaging

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