脑性瘫痪患儿脑细胞葡萄糖代谢与发育商关系的研究

Relationship between Glucose Metabolism of Brain Cells and Developmental Quotient of Children with Cerebral Palsy

目的:探讨脑瘫患儿脑细胞葡萄糖代谢与发育商(DQ)的关系。方法:符合脑瘫诊断标准的脑瘫患儿33例(脑瘫组),均采用Gesell发育量表(GDS)进行测试,同时进行18F-FDG脑显像检查(简称PET),并与健康自愿体检正常儿童(正常组)进行比较。结果:与正常组比较,脑瘫组中PET脑显像异常30例,正常3例;PET脑显像异常与动作能、应物能、应人能和言语能均有明显相关性;单灶低代谢灶其4个能区表现为轻度异常,多灶和弥漫低代谢灶则分别为中度和重度异常,且脑细胞葡萄糖代谢异常程度越重,DQ分值越低(P<0.05或0.01)。结论:脑细胞葡萄糖代谢异常可影响小儿的DQ状况。GDS结合PET脑显像检查可了解患者脑葡萄糖代谢功能和细胞活动功能,客观反映脑细胞损伤部位及程度,对于脑瘫患儿DQ状况的评估以及指导临床治疗具有重要意义。

Objective：To investigate the relationship between glucose metabolism of brain cells and the developmental quotient （DQ） of children with cerebral palsy. Methods.. Thirty-three children who met the standard of diagnosis of cerebral palsy were recruited as the study group, and all of them were tested by Gesell development schedules （GDS）, de- tected by 18F-FDG brain image, and the results were compared with the normal eontrol group. Results：There were 30 and 3 abnormal and normal PET brain images respectively in the study group and the normal control group. The abnormal PET brain imaging was significantly correlated with capabilities of action, reaction to objectives, reaction to person and language. The four energy areas of single-focus and low metabolic focus were slightly abnormal, while the multi-focus and diffused low metabolic focus were moderately and severely abnormal. The severer the level of glucose metabolism of brain cells was, the lower the score of DQ was （P〈0.05 or 0.01）. Conclusion： Abnormal glucose metabolism of brain cells would affect the scores of DQ of Children. GDS in combination with PET brain imaging could understand the function of glucose metabolism and activity of brain cells and reflex the areas and severity of the injury of brain cells objectively.