电刺激小脑顶核治疗脑微循环障碍所致脑缺血缺氧40例

Fastigial Nucleus Electrical Stimulation in Treating Cerebral Ischemia and Anoxia Caused by Cerebral Microcirculation Disfunction

目的观察电刺激小脑顶核(FNS)在人血液中红细胞形态及数目发生改变时引起的脑微循环障碍、脑功能失调、脑缺血、缺氧等症状时的治疗作用及机制。方法选取40例具有脑缺血、缺氧症候群的患者,随机分为两组,分别予以FNS治疗和服用尼莫地平片,共15 d;分别于治疗前,治疗后检查血常规、单光子发射计算机断层显像(single photon emission computed tomography,SPECT)。结果治疗前,血常规中红细胞各参数都有不同程度增高,并伴有SPECT的定性分析显示均有不同程度低灌注区;治疗后,应用FNS组红细胞各项参数均有所下调,并伴SPECT ROI区域计数的改善及SPECT的灌注缺损显著改善,临床症状随之减轻或消失,而尼莫地平组上述各项指标改善不明显,临床症状亦改善不明显。结论FNS能够干预红细胞,使之具有良好的红细胞变形能力(erythrocyte deformability,ED),使脑微循环得到有效灌注,从而纠正脑缺血、缺氧。

Objective To observe the curative effects and mechanisms of the fastigial nucleus electrical stimulation （FNS） for treating cerebral microcirculation dysfunction, cerebral function disturbance, cerebral ischemia and anoxia caused by the alteration of the number and configuration of human erythrocytes. Methods Forty patients with cerebral ischemia and anoxia symptoms were divided into two groups randomly. One group was given FNS and another group as control was treated with nimodipine for 15 d. Blood routine and the single photon emission computed tomography（SPECT） were performed separately before and after treatment. Results In blood routine before treatment, the various erythrocyte parameters were increased to different degrees and the SPECT qualitative analysis showed the low perfusion areas with different severities. After treatment, the various parameters of erythrocyte in the FNS group were decreased. The count of ROI area in SPECT and the perfusion defect in SPET were significantly improved. The clinical symptoms were alleviated or disappeared. But the above indexes in the nimodipine group had no obvious improvement and the improvement of symptoms was unobvi- ous too. Conclusion FNS can intervene with erythrocyte to make it has better erythrocyte deformability（ED） and contribute to effective perfusion of cerebral microcirculation, which are able to correct cerebral ischemia and anoxia.