慢性脑供血不足患者的脑电图及SPECT显像分析

Analysis of EEG and SPECT imaging in the patients with chronic cerebral circulation insufficiency

目的探讨脑电图、SPECT对慢性脑供血不足(CCCI)的诊断价值。方法对47例慢性脑供血不足患者行脑电图(EEG)检测,其中10例同时期行SPECT脑血流显像,分两年龄段观察脑电图的变化。结果脑电图正常11例,脑电图异常36例(76.60%),其中边缘状态脑电图41例,占87.23%;轻度异常脑电图4例,占8.51%;中度异常2例;<60岁组EEG的异常表现以泛化的慢α波为主,α活动减少、α波幅减低、调幅调节差。≥60岁组EEG改变无明显规律,出现了散在的或弥漫的θ波,同时可混有少量的δ波。两组患者均未见特异性EEG改变。10例行脑血流显像的患者SPECT结果均为阳性,表现为大脑实质广泛的血流灌注降低,以颞叶、额叶及顶叶血流降低最为明显。结论 SPECT脑血流显像能直接地评价脑组织学和功能改变;EEG对慢性脑供血不足患者的诊断还不具有特征性,但可在一定程度上反应脑缺血后脑细胞的功能改变,对慢性脑供血不足的诊疗有帮助。

Objective To study the clinical diagnostic value of electroencephalogram（EEG） and SPECT on chronic cerebral circulation insufficiency. Methods EEG was examined in 47 patients with chronic cerebral circulation insufficiency,and SPECT was examined in 10 patients of 47 patients with chronic cerebral circulation insufficiency. The changes of EEG in different ages were observed. Results The normal EEG was noted in 11 cases,and 36 cases（76.60%） showed abnormal EEG. Among them,marginal EEG in 41 cases（87.23%） ,mild abnormal EEG in 4 cases（8.51%） ,moderate abnormal EEG in 2 cases. The abnormal EEG presented reduced amplitude,reduced α wave activities and low and fat amplitude,and slow α wave and poor AM regulation in patients aged 60 years;no obvious regulation of EEG was observed in patients aged 60 years,but they occurred scattered or diffused θ wave at the same time,and could be mixed with a small amount of δ wave. No specific change in brain waves was observed in the three groups of patients. SPECT of 10 patients showed the decrease of the blood flow in bilateral cerebral hemisphere,and the decrease of the blood flow was noted significantly in parietal lobe,temporal lobe and frontal lobe. Conclusion SPECT image shows directly changes in the histology and function of the brain of chronic cerebral circulation insufficiency. The clinical diagnostic value of EEG on chronic cerebral circulation insufficiency is not distinctive,but it has a value in functional changes of brain cells after cerebral ischemia,and EEG is helpful for diagnosis of chronic cerebral circulation insufficiency.