^（133）Xe局部脑血流量在痴呆病中应用

Determination of ￣(133)Xe Regional Cerebral Blood Flow for the Diagnostic Use and Therapeutic Monitoring in Alzheimer's Diseases

目的：研究局部脑血流量定量测定在痴呆病人诊断和疗效监测中的临床价值。材料和方法：５５例痴呆病人应用１３３Ｘｅ吸入法和脑血流仪测定大脑半球和小脑－脑干（左右各分１４区）的平均和局部脑血流量（ｍＣＢＦ和ｒＣＢＦ），并转换为ｒＣＢＦ彩色地形图。５５例中１９例治疗前后进行了检测，部分病例与ＳＰＥＣＴ、Ｘ－ＣＴ和ＥＥＧ比较。结果：５５例病人见左右大脑ｍＣＢＦ降低，以多发性梗塞性痴呆（ＭＩＤ）和混合型（ＡＭ）较早老性痴呆（ＡＤ）为低，ｍＣＢＦ降低＞１．５ＳＤ以上者占７２．７％（左右侧），ｒＣＢＦ以顶叶降低最多，其次为枕、额和颞叶。１９例治疗前ｍＣＢＦ降低＞１．５ＳＤ以上者占８９．５％（左右侧）；治疗后ｍＣＢＦ降低者占７３．７％（左侧）和５７．９％（右侧）。ｒＣＢＦ以额、顶叶好转最为明显；其中以ＡＭ型明显，其次为ＭＩＤ和ＡＤ型。总好转率为３１．５％，个别病例好转十分明显。结论：１３３ＸｅｒＣＢＦ定量测定对痴呆症的诊断和疗效监测是较好的定量指标，值得推广运用。

Purpose:To study the diagnostic use and therapeutic monitoring of the 133Xe mean and regional cerebral bloodnow (mCBFand rCBF)determinaton in Alzheimer's Diseases(AD).Materials and Methods:The mCBF and rCBF of 19 cases of cerebral hemispheres and cerebellummeddulla in 55 cases of AD measured by 133Xe iuhalation and cerebragraphy were obtained together with their rCBF color images.Simultaneously also measured the mCBFand rCBF before and after traditional medicine therapy.Part of the cases compared with SPE CT,X-CT and EEG,Results:Right and left cerabral mCBF decreased in 55 cases by the order of MID.AM and AD. mCBF decreased over1.5SD about 72.7% (left and right),the rCBF increased more in parietal lobes,than the occiptal frontal and temperal lobes.After therapy mCBF decreased more in AM than MID and AD.The overall improved rate was 31.5%,and very significant in 3 individual cases.Conclusion:133Xe rCBF quantitative determination was a quite good parameter for the diagnosis and therapeutic monitoring in Alzhimer's diseases.And wide application was suggested.