脑外伤后综合征患者局部大脑血流量特征

Characteristics of regional cerebral blood flow in patients with post-traumatic syndrome

目的:观察脑外伤后综合征患者局部大脑血流量的变化规律,以寻找有效治疗方法。方法:选择1997-03／2004-11成都军区昆明总医院神经内科住院的脑外伤后综合征患者65例,为观察组,同期健康体检者44例,为对照组。局部大脑血流量测定采用上海海军医学研究所研制133Xe吸入HYS-1型局部大脑血流量测量系统。受检者闭目静卧,通过密闭的面罩吸入133Xe(由法国 CIS公司提供)与空气混合气体1 min(相当于吸入133Xe 148 MBq)。系统每 6 s自动采集数据1次,共测定12 min。检查时间统一在上午8-10点。受试者排除呼吸道疾病。结果:观察组双侧灰质每100 g脑组织局部大脑血流量广泛性减少[左灰质、右灰质分别为(38．30±6．06),(43．83±10．50)mL／min]。左侧比右侧明显, 其中额叶、颞叶和顶叶每100 g脑组织局部大脑血流量常有明显的局限性减少[左额、右额、左颞、右颞、左顶、右顶分别为(36．54±3．65),(48．40± 14．80),(42．88±9．21),(46.21±8．99),(43．29±9．18),(45．50±7．50)mL／min]。观察组左右额叶、颞叶和顶叶相比,左额叶每100 g脑组织局部大脑血流量减少更加明显[左额叶为(36．54±3．65)mL/min],双侧白质局部大脑血流量无显著性差异。结论:脑外伤后综合征患者存在明显的大脑血流量减少,以左侧灰质明显,额叶、颞叶和顶叶常有明显的局限性减少。上述改变可能是脑外伤后综合征发病的重要因素。

AIM：To observe the change laws of regional cerebral blood flow （rCBF） in patients with brain post-traumatic syndrome （PTS） in order to find effective therapeutic methods. METHODS： Sixty-five patients with PTS, who were hospitalized at the Department of Neurology, Kunming General Hospital of Chengdu Military Area Command of Chinese PLA between March 1997 and November 2004, were selected as observation group. Forty-four healthy people who took body examination in the same period were considered as control group. The rCBF was detected with rCBF measurement system of ^133Xe aspiration system of HYS-1 Type designed by Shanghai Navy Medical Institute. Testees laid down silently with eye closed, and sucked mixed gas （equal to suck ^133Xe 148 MBq） of ^133Xe （provided by French GIS company） and air through close mask for 1 minute. Data were gained by system automatically once, totally for 12 minutes. Checking time was from 8 to 10 am. The testees with respiratory disease were excluded. RESULTS： The rCBF of bi-gray matter decreased extensively in the observation group [it was （38.30±6.06） and （43.83±10.50）mL per minute in left gray matter and right .gray matter]. It was significant in the left side than that in the right side. The CBF decreased apparently at frontal lobe, temporal lobe and parietal lobe ]it was （36.54±3.65）, （48.40±14.80）, （42.88±9.21）, （46.21±8.99）, （43.29±9.18）, （45.50±7.50）mL per minute, respectively in the left frontal lobe, right frontal lobe, left temporal lobe, right temporal lobe, left parietal lobe and right parietal lobe]. Compared the left and right frontal lobe, temporal lobe and parietal lobe in the observation group, the decrease of CBF of left frontal lobe was significant [it was （36.54±3.65）mL per minute at left frontal lobe]. The rCBF in hi-white matter had no significant difference. CONCLUSION： The rCBF decreases markedly in patients with PTS, especially in left gray matter. Frontal lobes, temporal lobes and parietal lobes have distinct limited decrease. These changes can be important agents in episode of PTS.