精神分裂症患者脑供血情况与认知功能的研究

目的：探讨精神分裂症患者脑供血情况与认知功能之间的关系。方法：对精神分裂症患者100例进行听觉事件相关诱发电位（P300）检查，以评价其认知功能；对认知功能检查“差”和“极差”的患者进行经颅多普勒脑血流图（TCD）检查记录血流峰值及脉动指数，以了解其脑供血情况。结果：100例精神分裂症患者P300检查中有83例认知功能为“差”到“极差”，这83例患者TCD检查结果显示，大脑中动脉和大脑前动脉脉动指数均显著高于我国正常成人常模。结论：精神分裂症患者认知功能普遍较差，可能与其大脑中动脉、大脑前动脉血管舒缩调节功能下降导致大脑前额叶供血不足有关。     

精神分裂症患者脑血流速度的对照研究

目的了解精神分裂症患者脑血流速度的情况。方法运用多普勒超声仪测定６０例精神分裂症患者脑及颈动脉的血流速度，并与４０例健康正常人对照比较。结果发现精神分裂症患者双侧颈总动脉及右侧颈内动脉血流速度明显减慢，流向脑部的血液明显减少。左侧椎动脉、左侧大脑前及两侧小脑后下动脉的血流速度明显减慢。结论精神分裂症患者脑内局部血液供应减少。     

经颅多普勒检测拳击练习者的脑血流动力学变化★

目的：应用能无创检测颅内动脉血液生理情况的经颅多普勒技术观察拳击运动对脑血流动力学的影响。 方法：实验于2006-04/05在北京体育大学实验中心脑功能室完成。①分组：拳击练习组为8名平均参加拳击练习时间4.25年的男性拳击练习者，平均年龄（20.38±1.19）岁，平均身高（172.13±3.04）cm,，平均体质量（66.00±8.93）kg；对照组为7名男性无拳击练习史者，年龄、身高和体质量均与拳击练习组相匹配，从未参加过拳击运动练习。②评估指标：采用EDAN仪器有限公司产CBS--Ⅱ经颅多普勒对两组受试者的脑血流动力学指标进行检测和对比，指标包括大脑中动脉、大脑前动脉和大脑后动脉的收缩期峰血流速度、舒张末期峰血流速度、平均血流速度、搏动指数。 结果：15名受试者均进入结果分析。①拳击练习组和对照组大脑中动脉、大脑前动脉和大脑后动脉的收缩期峰血流速度、平均血流速度、舒张末期血流速度和搏动指数指标都在正常范围以内。②拳击练习组的大脑中动脉、大脑前动脉、和大脑后动脉的收缩期峰血流速度、平均血流速度、和舒张末期血流速度均低于对照组，而搏动指数均高于对照组，但各项指标在两组间比较差异均无显著性意义（P > 0.05）。 结论：拳击运动对练习者脑血流动力学的影响不大，也不会显著地降低其大脑灌注压。     

尼麦角林对偏头痛患者脑血流的影响

目的研究尼麦角林对成人偏头痛患者脑血流动力学的影响。方法156例偏头痛患者随机分为试验组（76例）和对照组（80例）,同时选择60例健康体检者作为健康对照组,试验组应用尼麦角林治疗,而对照组应用布洛芬治疗,应用经颅多普勒超声（TCD）技术检测试验组和对照组治疗前后及健康对照组双侧大脑中动脉、大脑前动脉、大脑后动脉的收缩期峰值血流变化。结果（1）156例偏头痛患者服药前头痛侧与非头痛侧比较,大脑中动脉、大脑前动脉、大脑后动脉的收缩期峰值血流速度（Vs）有显著差异;两组头痛侧之间及非头痛侧之间无显著性差异。治疗后比较,对照组差异明显,试验组无明显差异;两组头痛侧比较有显著性差异;（2）156倒患者服药前头痛侧大脑中动脉、大脑前动脉、大脑后动脉的收缩期峰值血流速度与健康对照组比较增快。治疗后：对照组变化不明显;试验组头痛侧大脑中动脉、大脑前动脉、大脑后动脉的收缩期峰值血流速度降低,且与健康对照组差异不明显。结论尼麦角林可明显改善偏头痛患者的脑血流,防止偏头痛的发作。     

精神分裂症患者TCD对照研究

探讨精神分裂症患者脑内动脉和脑血流速度的变化，为其治疗提供客观依据。应用TCD检测40例精神分裂症患者脑内动脉的各项参数与20例正常组进行对照研究，结果显示精神分裂症患者右侧大脑后动脉、前动脉及左侧前动脉、椎动脉的搏动指数或和阻力指数显著降低（P＜0.05或0.01)。女性患者左侧大脑中动脉、前动脉血流速度较女性对照组显著降低（P＜0.05)。提示精神分裂症患者部分脑内动脉血管弹性减退、阻力增高、血管紧张度增高，女性患者左侧大脑优势半球动脉损害比较严重。在精神分裂症治疗时，合并活血化瘀及改善脑血管弹性药物，可以进一步提高疗效。     

抑郁症患者脑血流速度的研究

运用经颅多普勒超声器测定２２例抑郁症患者脑及颈动脉的血流速度，并与健康正常人进行对照，发现抑郁症患者双侧颈总动脉及颈内动脉血流速度明显减慢，供应给脑部的血流减少；右侧大脑中动脉吸大脑后动脉血流速度偿性加快，脑及颈动脉血流速度的改变与Ｈａｍｉｌｔｏｎ抑郁量表总分无明显相关，提示抑郁症患者大脑半球左侧供血障碍更加明显，但脑血流测量的结果并不能反映疾病的严重程度，仅为抑郁症病因研究提供了有益的线索。     

首发精神分裂症脑血流对照分析

我们对精神分裂症患者的局部脑血流进行研究。1　资料与方法患者均符合国际疾病分类第 10版精神分裂症的诊断标准 ;首次患病年龄 10～ 30岁 ;排除器质性疾病 ;近期未使用任何血管活性物质。共 10 0例。其中男 80例 ,女 2 0例 ;年龄16～ 30岁 ,平均 (2 3 8± 6 8)岁。以 6 0名健康者为对照 ,其中男 4 4例 ,女 16例。两组性别与年龄差异均无显著性 (Ｐ均>0 0 5 )。患者于治疗前用经颅多普勒诊断仪 (ＴＣＤ)对大脑动脉血流速度进行测定 ,不合作者治疗 1周后补查。统计学处理采用ｕ检验及卡方检验。2　结果患者组左右大脑前动脉平均血流速度均…     

精神分裂症经颅彩色多普勒超声检测分析

目的 初步探讨精神分裂症患者的脑动脉血流动力学改变。方法 应用经颅彩色多普勒超声(TCD)检测108例精神分裂症患者,并与31例正常人TCD检测进行对照。结果 精神分裂症患者中有78例(72.2％)TCD诊断异常,对照组中有9例(29.0％)TCD诊断异常,两组异常率有显著性差异(P<0.001);TCD诊断异常主要表现为动脉的痉挛、痉挛伴扩张、弹性下降、硬化及供血不足等;这些异常多发生在大脑前动脉、颈总动脉、基底动脉、椎动脉和大脑中动脉等。结论 精神分裂症患者可能存在脑动脉血流动力学改变,因此造成脑部血流灌注量减少。初步认为,TCD对精神分裂症的病因、诊断和治疗研究可能具有一定的参考价值。     

发作期抑郁症患者脑动脉血流速度与注意力、执行功能关系

目的探讨发作期抑郁症患者脑动脉血流速度及其与注意力、执行功能的关系。方法 70例发作期抑郁症患者及65名健康对照纳入研究。采用24项汉密尔顿抑郁量表(24 items Hamilton depression scale,HAMD-24)评估抑郁症患者抑郁情绪,划销测验(cancellation test,CT)、威斯康星卡片分类测验(Wisconsin card sorting test,WCST)评估的认知功能,采用经颅多普勒超声(transcranial Doppler,TCD)检测脑动脉血流速度。结果与对照组比较,发作期抑郁症患者基底动脉、左侧大脑中动脉、右侧大脑中动脉、左大脑前动脉与右大脑前动脉平均血流速度均减慢,差异具有统计学意义(P0.05)。患者组CT各阶段净分及总净分低于对照组,而WCST总应答数、错误应答数、持续性错误数、完成第一个分类所需应答数均高于对照组,差异具有统计学意义(P0.01)。发作期抑郁症患者大脑基底动脉(r=0.25)、左中动脉(r=0.46)、右中动脉(r=0.25)、右后动脉(r=0.26)平均血流速度与CT总净分呈正相关(P0.05),各大脑动脉平均血流速度与WCST总应答数、持续性错误数呈负相关(P0.05),基底动脉、左右后动脉与错误应答数、完成第一个分类所需应答数呈负相关(P0.05)。结论发作期抑郁症患者大脑动脉平均血流速度普遍降低,注意力与执行功能受损。认知功能受损可能与脑动脉平均血流速度的改变有关。     

抑郁症患者抗抑郁剂治疗前后脑动脉血流速度的改变及与认知功能的关系

目的:探讨短期治疗后抑郁症患者脑动脉血流速度的变化及其与注意力、执行功能的关系。方法:采用汉密尔顿抑郁量表(HAMD)评估70例抑郁症患者(抑郁症组)抑郁情绪,采用划销测验、威斯康星卡片分类测验(WCST)测试抑郁症组和65名健康对照者(健康对照组)的认知功能;运用经颅多普勒超声检测两组脑动脉血流速度,抑郁症组在抗抑郁治疗4~8周后再次重测。结果:短期治疗后抑郁症组基底动脉血流速度较治疗前增快(t=2.45,P0.05),但左、右大脑中动脉、左、右大脑前动脉血流速度仍低于健康对照组(t=-6.07~-12.14;P均0.01);治疗后抑郁症组划销测验成绩较治疗前明显提高,但除净分IV外仍低于健康对照组(t=-2.54~-17.33;P0.05或P0.01);WCST错误应答数、持续性错误数均较治疗前减少,但仍多于健康对照组(t=9.33~15.13;P均0.01)。相关分析显示,治疗后大脑动脉平均血流速度与划销测验、WCST成绩显著相关(P0.05或P0.01);椎动脉血流速度差值与划销测验总净分差值、WCST错误应答数差值及持续性错误数差值呈正相关(r=0.454,0.270,0.378;P均0.01)。结论:短期治疗后抑郁症患者脑动脉平均血流速度与注意力、执行功能均得到一定程度的改善,但仍未恢复到正常状态;注意力与执行功能受损可能与脑动脉平均血流速度的改变有关。     

Microanatomy of the perforators of the anterior communicating artery complex

We describe the microanatomy of the perforating arteries arising from the anterior communicating artery complex (5 mm distal of the anterior cerebral artery, the anterior communicating artery, and 5 mm proximal of the distal anterior cerebral artery). Thirteen unfixed human brains were used in this study. The origin and number of perforators are described, as is the site of brain penetration, and results are correlated with previous studies. The hemodynamics of blood flow ib relation to the formation of an anterior communicating artery aneurysm and different surgical approaches are mentioned. The neuropsychological outcome after aneurysm clipping with regards to the pattern of blood supply from the anterior cerebral artery complex is also discussed. [Neural Res 1997; 19: 577-587]     

长春西汀对认知功能障碍的疗效观察

目的：探讨长春西汀对恢复期精神裂症患者认知功能障碍的治疗作用。方法：对31例疗效已达显著进步以上的精神分裂症患者，随机分为研究组（16例）和对照组（15例），在予长春西汀治疗前、后、对两组患者分别评定其认知障碍及脑血流状况，进行分析。结果：研究组治疗前后有显著好转，而对照组差异无显著性。结论：长春西汀对改善精神分裂症患者的认知障碍有益。     

Arterial patterns of the rat rhinencephalon and related structures

Course and distribution information on arteries in the rat rhinencephalon was not found in the literature. Such data are useful for designing experiments and interpreting findings, tracing nerve fibers on or to intracerebral vessels, and in considering routes for diffusion or transport of intracerebral injected agents. Adult rats were perfused with silicone rubber and many brains were cleared in glycerin. The major arteries to the olfactory bulb stem from the anterior cerebral artery. A middle cerebral arterial ramus could provide a collateral source. The septum receives supply exclusively from the anterior cerebral artery. A rostral lesion in the medial septum would most likely involve arteries supplying more caudal structures including hippocampal afferent and efferent fibers. No anastomoses between septal arteries or with middle or posterior cerebral arterial rami were observed. The cingulate cortex receives anterior cerebral arterial branches with the middle cerebral artery being a collateral source. The amygdala and overlying cortex receive branches of the internal carotid and middle cerebral arteries. Transverse arteries in the hippocampal fissure stem from the longitudinal hippocampal artery, a branch of the posterior cerebral artery, to nourish the hippocampus and portions of the fascia dentata. Other branches supply the remainder of the fascia dentata, entorhinal and subicular structures, and certain vessels anastomose with middle cerebral arterial rami. A transverse artery occlusion would probably result in a lesion: No intracerebral arterial anastomoses were observed. Vascular compensation may occur following occlusion of the longitudinal artery via supply from the middle cerebral artery.     

创伤后应激障碍的认知功能与脑血流情况研究

目的 探讨创伤后应激障碍患者的认知功能状况、脑血流情况及其之间的关系.方法 对100例创伤后应激障碍患者进行听觉事件相关诱发电位（P300）检查以评价其认知功能.对认知功能＂差＂和＂极差＂的患者进行多普勒脑血流图TCD检查,记录血流峰值及脉动指数,以评价其脑血流情况.结果 100例创伤后应激障碍患者P300检查中,84例认知功能为＂差＂和＂极差＂,该84例患者TCD检查结果显示：大脑中动脉和大脑前动脉的动脉指数均高于我国正常成人常模,差异有显著性.结论 多数创伤后应激障碍者的认知功能出现障碍,可能与其大脑中动脉、大脑前动脉血管收缩调节功能下降导致大脑前额叶供血不足有关.     

DSCTA联合早期疗效的评价CTPI对颅内外动脉吻合术后

目的联合应用数字减影CT血管造影(DSCTA)和CT灌注成像(CTPI)对颅内外动脉吻合术(EIAB)后早期疗效进行评价。方法因脑血管疾病经受了EIAB的患者18例,其中9例行术后DSCTA检查,13例行手术前后CTPI检查,其中4例同时接受手术前后CTPI检查和术后DSCTA检查。结果 CTPI显示8例术后脑血供明显改善,表现为原异常灌注区域范围减小,部分吻合血管周围脑组织呈过度灌注状态,脑血容量、脑血流量明显增加,平均通过时间明显缩短(P0.05);3例术后脑血供无明显变化;2例脑血供减少。术后DSCTA显示搭桥血管通畅7条,闭塞3条。DSCTA可清楚显示旁路血管全程及吻合口的部位、大小或宽度。多平面重组(MPR)和去骨结构容积再现重建均可清楚显示搭桥血管及吻合口,但MRP更有助于测量吻合口的宽度。结论联合应用DSCTA和CTPI成像技术可对EIAB后早期疗效进行无创性定量评估,具有良好的临床应用前景。     

PET study on cerebral hemodynamics in internal carotid artery occlusion--the pathogenesis of watershed infarction

We studied positron emission tomography in nine patients with unilateral internal carotid artery occlusion, selected as having good collateral circulation through the anterior portion of the circle of Willis. Analyses of regional cerebral blood flow, cerebral oxygen metabolic rate, oxygen extraction fraction, and cerebral blood volume allowed quantitative evaluation of the regional hemodynamic status, especially in relation to watershed area. The patient group has a significantly (p less than 0.01) decreased regional blood flow in the middle cerebral artery territory and the surrounding watershed areas of the occluded hemisphere, as compared with eight control subjects. Values of oxygen extraction fraction became progressively greater farther from the circle of Willis, attaining the highest level in the superior parietal and posterior temporal-occipital watershed area. Oxygen extraction fraction gave information on the balance of energy supply and demand, serving as an index of the oxygen carriage reserve. A concomitant decrease in the ratio of cerebral blood flow to volume suggested reduction in mean flow velocity with possible development of "stagnation thrombus". These findings suggest 1) hemodynamic vulnerability of watershed areas after internal carotid artery occlusion and 2) importance of systemic hemodynamic factors such as blood pressure and circulating blood volume in the genesis of watershed infarctions.     

Unusual anomaly of the anterior cerebral artery: report of a case

The rare occurrence of a low intracavernous internal carotid bifuraction is reported. The anterior cerebral blood supply emanated from this source. Two separate aneurysms at the bifurcation of the anomalous single anterior cerebral artery were operated on one year apart.     

Tertiary microvascular territories define lacunar infarcts in the basal ganglia

Lacunar infarcts are commonly found in the basal ganglia, though little is known about the organization of small-scale microvascular territories that presumably subtend lacunae. We investigated microvascular territories of the lenticulostriate arteries, the recurrent artery of Heubner, the anterior choroidal artery, and striate branches of the anterior cerebral and anterior communicating arteries in perfusion-fixed human brains by simultaneous injection of fluorescent dyes and a radio-opaque substance in 5% gelatin. Territories were defined by ultraviolet illumination of dye and high-resolution mammography of radio-opaque substance. Brains were sectioned coplanar with the Talairach proportional grid system and vascular data were plotted, allowing for application to any human brain. The data suggest first that the lenticulostriate artery, recurrent artery of Heubner, and anterior choroidal artery supply distinct territories of the basal ganglia with minimal overlap and sparse anastomoses between major penetrating vessels. Individual territories are spatially consistent across brains and match the extent of major/minor infarcts. Second, branching patterns of parental, second-, and third-order vessels leading to circumscribed terminal vascular beds could account structurally for "lacunar" infarcts.     

Comparative anatomy of the arterial vascularization of the hippocampus in man and in experimental animals (cat, rabbit and sheep).

The studies were performed by the authors' injection method on 30 human brains and 80 animal ones. The cerebral arteries were injected with synthetic coloured latex and then prepared in an operating microscope. It was found that the main source of arterial supply of both the human and animal hippocampus is the posterior cerebral artery. However, this artery has different origins in the arterial circle of the brain in man, cat, rabbit and sheep. Comparative investigations have also proved that the hippocampal vascular system in man and animals is very similar. It is formed by branches of the posterior cerebral artery and of the anterior choroidal artery, called the hippocampal arteries, and by numerous internal hippocampal arterioles arising from them at right angle. The regional distribution of these arterioles is impossible to describe because of their variable course in the hippocampal cortex and of the similar vascularization of different cortical areas of the hippocampus. The studies have also shown that the hippocampal arterial system is very well developed and makes collateral circulation possible. Extracerebral segments of the hippocampal arterioles in human senile brains, and chiefly in brains with atherosclerosis, showed different deformations in the form of siphon-like structures, knot-loops and vascular glomeruli.