急性脑梗塞病人神经机能失联络现象的临床研究

目的：探讨急性缺血性脑血管病后神经机能失联络现象及其临床意义。方法：采用９９ｍＴｃ－ＥＣＤ－ＳＰＥＣＴ技术，动态观测３６例急性单侧基底节梗塞患者脑血流的变化，同时评估患者的神经系统体征及脑梗塞的体积。结果：在发病３．４ｄ内，１１例（约３１％）患者出现了不同程度的神经机能失联络，表现为梗塞灶对侧小脑（８例）、同侧顶区（２例）和同侧枕区（１例）的血流量减少。此１１例患者脑梗塞体积明显大于２５例无神经机能失联络现象者（Ｐ＜０．０５）。两组病人入院时神经功能缺损积分相近，但前者３周后的积分明显大于后者。结论：急性脑梗塞后神经机能失联络的出现可能是神经系统功能预后不良的一个指标。

Study of Diaschisis in Patients with Acute Cerebral Infarction

Objective:To investigate the diaschisis and its complication in patients with acute cerebral infarction.Method:The regional cerebral blood flows(rCBF) were measured by 99m TcECDsinglephoto emission computed tomography(SPECT) in 36 patients with unilateral basal ganglia infarct.At the same time,the neurologic deficit score(NDS) and infartion areas(IA's) were also evaluated.Results:Eleven cases of diaschisis were identified at the first SPECT scan,which was made at an average of 3.4 days after ictus,and manifested by the lower CBF in the region of the contralateral cerebellar hemisphere (8 cases),the ipsilateral parietal cortex (2 cases) and the ipsilateral occipital cortex(1 case).It was aslo found that their average IA was significantly larger than that of 25 patients without diaschisis( P <0.05).But there was no marked difference in NDS between these two groups.Conclusion:It is suggested that the diaschisis after acute cerebral infarcion might be a useful predicator for neurological outcome.