CCVI患者局部脑血流量及血流动力学改变的临床研究

目的观察慢性脑血管功能不全（CCVI）患者局部脑血流量（rCBF）及脑血流动力学改变。方法对20例经头颅CT或MRI检查证实无脑组织结构异常、临床确诊为CCVI患者行SPECT显像及经颅多普勒超声（TCD）检查，分别测定rCBF、局部脑血流量降低百分比、脑动脉的平均血流速度（MV）、脑动脉搏动指数（PI）。对照组为年龄、性别相匹配的正常者。结果20例CCVI患者中，95％（19／20）患者出现rCBF减少，主要灌注降低区为额叶、颞叶、顶叶、基底节。80％（16／20）患者大脑前动脉、大脑中动脉血流速度加快。结论对CCVI患者进行rCBF及TCD检测，有助于观察病变部位脑血流量及血流动力学变化，对其临床早期诊断和治疗有着重要意义。早期脑血流量变化可提示患者预后，为选择合理治疗方案提供客观依据。

Preliminary clinical study of regional cerebral blood flow and hemodynamics in patients with chronic cerebrovascular insufficiency

Objective To explore the changes in regional cerebral blood flow(rCBF)and cerebral hemodynamics in patients with CCVI.Methods Twenty patients diagnosed as CCVI were enrolled to undergo single photon emission computed tomography(SPECT)rCBF imaging or transcranial Doppler uhrasonography(TCD)examination.All the patients were free from cerebral structural abnormalities as demonstrated by X-CT or magnetic resonance imaging(MRI).Cranial arteries blood flow velocity,pulsating index(PI)were measured by TCD and compared with the mean of rCBF as measured by SPECT.Results On SPECT images, decreased rCBF lesions were found in 95 percent of patients(19/20).The areas of hypoperfusion were mainly located in frontal,temporal,parietal lobes and fondues nodus.Increased cranial arteries blood flow velocity was found in the anterior cerebral artery(ACA)and middle cerebral artery(MCA)in 80 percent of patients (16/20).There were no correlations among rCBF,the decreased percentage of rCBF,average velocity,and PI of cranial arteries.Conclusions By performing SPECT rCBF and TCD on CCVI patients,the degree of changes in rCBF and hemodynamics Can be evaluated easily,which is valuable for early clinical diagnosis and treatment of CCVI.