脑梗死后失语与局部脑血流的相关性研究

Study on the relations between cerebral infarction aphasia and reginal cerebral blood flow

目的探讨卒中后失语与局部脑血流(rCBF)之间的关系。方法选择51例经CT或MRI确诊的左侧半球单一病灶的脑梗死患者行单光子发射型计算机体层摄影术(SPECT)检查,观察rCBF改变的部位、范围及程度,并按北京大学高素荣汉语成套检测法(ABC)进行失语检测,记录失语评分,并进行分类,分析rCBF与失语的关系。结果 51例患者均有左侧大脑皮质灌注不足的表现;失语组与非失语组对比,失语组SPECT显示缺血脑叶的数量明显多于非失语组(P<0.05);脑梗死后失语组各部位的rCBF比值均低于非失语组,其中,两组病例的Broca区、Wernicke区及颞叶rCBF比值,失语组降低明显,差异有统计学意义(P<0.05)。结论脑梗死失语与病灶部位有关,但与脑皮质语言区脑血流灌注量降低及降低程度的关系更密切。

Objective To explore the relations between post-stroke aphasia and regional cerebral blood flow （rCBF）. Methods 51 patients diagnosed by CT or MRI with cerebral infarction caused by left hemisphere single lesion were examined by SPECT, and the locations, scales and degrees of rCBF change were observed. The aphasia was assessed by ABC and then scored and categorized. The relations between rCBF and aphasia were then analyzed. Results 51 pa- tients all showed left brain cortical hypoperfusion. Compared with non-aphasia patients, the number of lobes with is chemia in aphasia patients was significantly higher than that in non-aphasia patients （P〈0.05）. After cerebral infarction, all rCBF ratios of different locations for aphasia patients were lower than that for non-aphasia patients, in which the rCBF ratios of Broca area, Wernicke area and temporal lobe were significantly lower in aphasia patients （P〈0.05）, and the difference was statistically significant （P〈0.05）. Conclusion The cerebral infarction aphasia is related to the locations of lesion, but it has closer relations to the decrease of cerebral blood flow perfusion in language cortex and the degree of decrease.