短暂性脑缺血发作间期局部脑血流及脑细胞功能状态

目的 通过对短暂性脑缺血发作(TIA)患者发作间期局部脑血流及脑细胞功能状态的研究，探讨TIA的有效治疗依据。方法 41例处于发作间期的TIA患者与55名做对照的健康成人均行单光子发射电子计算机断层显像(single-photon emission computed tomography，SPECT)、CT灌注成像(computed tomography perfusion imaging，CTPI)和正电子发射体层摄影术(positron-emission tomography，PET)等检查，对检查结果进行相关分析。结果 SPECT显示放射稀疏和(或)缺损39例，检出率为95．1％。CTPI显示灌注异常26例，检出率为63．4％，提示TIA发作间期仍有半数以上存在相应区域局部脑血流动力异常。而对于CTPI显示脑血流正常者，SPECT仍显示有放射稀疏和(或)缺损，考虑为局部脑细胞功能减低所致，PET检测结果亦显示细胞代谢异常。结论 TIA发作间期患者虽无临床症状及体征，但脑细胞功能未完全恢复正常，部分患者仍处于脑血流异常状态。提示临床医师应重视TIA患者的治疗，防止TIA复发，预防脑梗死的发生。

Regional cerebral blood flow and the function of neurocyte in intermission of transient ischemic attacks

Objective To investigate the evidence of effective therapy of transient ischemic attacks (TIA) through the study on the regional cerebral blood flow and the function of neurocyte in the symptom free phase Methods Forty one patients with TIA and 45 controls were examined by single photon emission computed tomography (SPECT), computed tomography cerebral perfusion imaging (CTPI) and the positron emission tomography (PET) Results The abnormal rate of SPECT examination was 95 1%, and abnormal perfusion rate of CTPI was 63 4% These results revealed that there were reduction of regional cerebral blood flow in above half of TIA patients SPECT showed abnormal in some patients with normal CTPI show, which was possibly because of abnormal function of neurocyte, and the latter was confirmed by PET Conclusion Patients with TIA should have not only abnormal function of neurocyte, but also have reduction of regional cerebral blood flow in the intermittent phase The therapy of TIA should be emphasized in order to prevent TIA relapse and the occurrence of irreversible changes