血管神经性头痛患者脑血流灌注影像特点及临床研究

目的利用单光子发射计算机断层扫描（SPECT）脑灌注显像技术,观察针刺对血管神经性头痛患者局部脑血流灌注量的改变情况,探讨血管神经性头痛患者针刺前后局部脑功能状态和SPECT技术对针刺治疗血管神经性头痛疗效判定的临床应用价值。方法对38例符合临床血管神经性头痛诊断标准的患者针刺前后分别进行了SPECT 99mTc-ECD脑灌注显像检查,并对此类患者针刺前后局部脑血流灌注改变和易损部位进行统计学分析。结果 38例血管神经性头痛患者SPECT检查中发现大脑皮质不同的功能区均有不同程度的血流灌注异常,以额叶和颞叶功能受损最常见。血管神经性头痛患者针刺前后,血流灌注降低病灶放射性摄取改变差异显著,通过结果分析,可以得出针刺可使血管神经性头痛患者脑血流灌注降低病灶增加放射性摄取,即明显改善了局部脑血流灌注量。结论应用SPECT显像技术可直接观察血管神经性头痛患者针刺前后局部脑血流灌注量的改变情况,可客观定量分析针刺治疗效果,对以后评价、判断治疗疗效和针刺选穴等方面的工作打下良好的基础,是一种直观可行的客观研究手段。

Characteristics of brain perfusion imaging of patients with angioneurotic headache and clinical research

Objective To study the effects of acupuncture on regional cerebral blood flow（rCBF） of patients with angioneurotic headache and study the clinical value of single photon emission computed tomography（SPECT） brain perfusion imaging in the evaluation of brain function before and after acupuncture.Methods Thirty-nine patients with angioneurotic headache received 99mTc-ECD SPECT b2rain perfusion imaging before and after acupuncture respectively.The changes of rCBF were calculated and the damaged brain areas were determined by statistical analysis.Results SPECT brain perfusion imaging showed different levels of rCBF abnormality some brain areas of angioneurotic headache patients,and for most patients the frontal lobe and temporal lobe were the most commonly affected areas.The low rCBF of affected brain areas were significantly improved after the treatment of acupuncture.Conclusion As an objective and viable research method,SPECT brain perfusion imaging can be used to directly observe the rCBF changes of patients with angioneurotic headache and evaluate the therapeutic efficacy of acupuncture,and may also be potentially applied in the acupoint selection.