高血压性脑出血患者局部脑血流变化的临床意义

CIinical Significance of RegionaI CerebraI FIow Changes and CIinical Manifestation in Patients with Hypertensive IntracerebraI Hemorrhage

目的探讨高血压性脑出血(ICH)患者局部脑血流(rCBF)变化的意义。方法对60例ICH患者和31例对照者行脑血流单光子发射断层扫描(SPECT)显像,判定rCBF改变的部位及范围,并结合临床表现进行分析。结果ICH远离出血灶的同侧、对侧大脑半球和对侧小脑半球缺血发生率分别为70.0%、35.0%、和50.0%。基底节出血最常引起皮层失联络的部位是额叶(81.5%),其次是颞叶(68%)、顶叶(60.5%)、对侧小脑(48.5%)和枕叶(28%)。肢瘫越重者发生对侧小脑失联络现象越高。结论脑出血可引起远离出血灶的大脑半球及对侧小脑半球缺血。随着病情改善,rCBF也有所恢复。

Objective ：To study the changes of regional cerebral blood flow （rCBF） in patients with hypertensive intracerebral hemorrhage （ICH） and analyse the relation between rCBF changes and clinical manifestation. Methods：rCBF perfusion imaging with SPECT was performed in 60 patients with ICH and 31 normal subjects. The relative analysis was made between rCBF changes and clinicalmanifestation Results ：Ther ate of brain ischemia caused by ICH far away from the origin in eithereerebral hemisphere and contralatetra cerebellar henaisphere were 70.0% ,35.0% and 50.0%. The patients with basalnuclei hemorrhage had damages in the frontal cortex mostly （81.5 % ）, temporal（68 % ）, parietal （60.5 % ）, occipital （ 28 % ） cortex and contlalatera cerebellar hemisphere （ 48.5 % ） secondly. The hemiplegia cases damaged more seriously had mire crossedc erebral--cerebeilar diaschisis. Conclusion：ICH can cause brain ischemia far away from thd origin in either cerebral hemisphere and contlalatera cerebellar hemisphere. As ICH recovered, improvement of rCBF or return to normal were also observed.