急性脑出血患者局部脑血流量的研究

目的　研究急性脑出血患者血肿区、周边区及其对侧脑组织局部脑血流量(rCBF)的动态变化。方法　利用单光子发射断层扫描(SPECT)技术检查15例急性基底节区出血患者,根据中国卒中评分分型,轻型组10例,中型组5例,发病后3d和16d各做1次SPECT检查。采用感兴趣区模型分析法,分别于rCBF减低区的中心和其周边区的额顶叶、小脑中心区及上述区域的对侧镜像区做放射性摄取计数,并计算病变侧与对侧放射性计数的摄取比(R)。结果　轻型组患者第2次检查时血肿周边区和对侧镜像区放射性计数比较差异有显著性(P<0 .05),中型组患者差异无显著性(P>0 .05);病变对侧小脑的放射性计数低于病侧小脑(P<0. 01)。结论　急性脑出血患者血肿区及其周边区的rCBF下降;血肿对侧小脑的血流量亦有下降。

Study of regional cerebral blood flow in the patients with acute intracerebral hemorrhage

Objective To study the dynamic changes of regional cerebral blood flow(rCBF) in hematoma, perihematoma and their enantiomorph in the contralateral hemisphere in the patients with acute intracerebral hemorrhage(ICH). Methods 15 patients of acute basal ganglia hemorrhage were divided into different groups according to the Chinese Stroke Scales, 10 patients were minor, the other 5 patients were moderate. 99mtechnetium-ethyl -cysteinate-dimer single-photon emission CT ( 99mTc-ECD SPECT) were performed within 3 days after onset of the disease and re-examined at 16 days. The method of region of interesting (ROI) was used to measure the uptake counts in the core of hematoma, frontal or parietal region around the lesion, the center of cerebellum and their enantiomorphs in the contralateral hemisphere, respectively,and to calculate the ratio of uptake counts.Results The uptake counts showed difference in the second time exam between perilesion and its enantiomorph in minor patients ( P<0.05),it showed no significant difference in moderate patients (P>0.05). The uptake counts of contralateral cerebellum were less than those of hemorrhage lateral cerebellum ( P<0.01).Conclusion The rCBF of hematoma and perihematoma decreased in patients with acute intracerebral hemorrhage and it also declined in the contralateral cerebellum.