摘要
目的探讨酸性磷脂(AP)在临床早期评估颅内外动脉狭窄患者脑缺氧缺血程度中的作用。方法患者均经磁共振弥散加权成像(DWI)、灌注成像(PWI)检查,并排除急性脑梗死,在低灌注区或可疑低灌注区选取PWI像感兴趣区域测脑血流量(CBF)、脑血容积(CBV)和平均通过时间(MTT)值,同时取对侧镜像对称区域测CBF、CBV及MTT值做对照研究。立即抽静脉血测AP的浓度,并应用线性相关分析法比较AP与症状性颅内外动脉狭窄患者PWI相关系数(CBF、CBV和MTT)的相关性。结果 30例患者PWI异常,AP值均高于正常参考值;8例患者PWI和AP值均正常;7例患者PWI虽正常,但AP值高于正常参考值。灌注感兴趣区域及镜像侧CBF、CBV及MTT比较均存在显著性差异(P均<0.01)。多根血管狭窄患者CBF和CBV较单根血管狭窄患者减低,MTT延长,AP值增高。CBF与AP值呈负相关(P<0.01),CBV与AP值亦呈负相关(P<0.01),MTT与AP值呈正相关(P<0.01)。结论 CBF、CBV、MTT与AP间存在明显的相关性,AP是一种脑组织缺氧缺血的早期敏感的标志物,有可能较PWI成像更早期反映脑组织缺氧缺血程度。
Objective It is to approach the action of AP in determining the extent of cerebral ischemia and hypoxia early for patients with symptomatic intracranial or extracranial arterial stenosis.Methods All patients were characterized by magnetic resonance images,diffusion-weighted imaging（DWI）,perfusion weighted imaging（PWI）.PWI regions of interest in low perfusion area or suspicious such as drip irrigation was selected to measure cerebral blood flow（CBF）,cerebral blood volume（CBV） and mean transit time（MTT） values.At the same time took the opposite mirror-image area measuring CBF,CBV,and MTT value of control study,and venous blood samples were drew off immediately to measure the concentration of AP.Relevance of the concentration of AP and CBF,CBV and MTT of PWI-related factors were compared by linear correlation analysis.Results Thirty patients with abnormal of PWI and AP;eight patients with normal of PWI and AP;7 patients with normal PWI and abnormal of AP.CBF,CBV and MTT of interest region both sides of PWI were significant differences.CBF and CBV in patients with multi-vascular stenosis were degraded than patients with simple-vascular stenosis;MTT and AP were increased.CBF was negatively correlated with AP（P0.01）;CBV was negatively correlated with AP（P0.01）;MTT was positively correlated with AP（P0.01）.Conclusion CBF,CBV and MTT are positively correlated with AP.AP is the early and sensitive marker after cerebral ischemia and hypoxia,it may be earlier reflecting the degree of brain tissue ischemia and hypoxia than PWI.
出处
《现代中西医结合杂志》
CAS
2011年第36期4599-4601,4627,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
内蒙古自然科学基金资助项目(NO200711020923)
关键词
酸性磷脂
灌注成像
对照评估研究
症状性颅内外动脉狭窄
acidic phospholipid
perfusion imaging
evaluation study
symptomatic intracranial or extracranial arterial stenosis
