正电子发射断层扫描和统计参数图观察肢体缺血预适应对缺血型烟雾病患者脑代谢的影响

Effects of Limb Ischemic Preconditioning on Brain Metabolism of Ischemic Moyamoya Disease: A Positron Emission Tomography and Statistical Parametric Mapping Study

目的利用正电子发射断层扫描(PET)和统计参数图(SPM)观察烟雾病患者肢体缺血预适应治疗前后脑葡萄糖代谢的变化。方法门诊缺血型烟雾病患者62例,随机纳入肢体缺血预适应组(n=31)和对照组(n=31)。治疗前和治疗6个月后行PET成像检查。采用比值法和SPM法对2组患者治疗前后的脑葡萄糖代谢显像结果进行分析。结果肢体缺血预适应组好转情况明显优于对照组(P<0.01),进展情况显著轻于对照组(P<0.001)。设治疗后代谢增加,肢体缺血预适应组得到7个有统计学意义的代谢激活区,包括额叶、颞叶、顶叶,总KE=1121;对照组得到5个具有统计学意义的代谢激活区,包括额叶和顶叶,总KE=292。设治疗后代谢减低,肢体缺血预适应组得到1个具有统计学意义的代谢激活区,位于额叶;对照组得到8个具有统计学意义的代谢激活区,包括额叶、顶叶、枕叶,总KE=629。结论 PET和SPM能观察到肢体缺血预适应治疗后缺血型烟雾病患者脑葡萄糖代谢的变化情况。

Objective To observe the brain glucose metabolism after limb ischemic preconditioning（LIPC） for ischemic moyamoya disease with positron emission tomography（PET） and statistical parametric mapping（SPM）. Methods 62 patients with ischemic moyamoya disease were enrolled and randomized into LIPC group（n=31） and control group（n=31）. The glucose metabolism of patients was analyzed with PET before and after treatment in both groups, using the methods of radioactivity ratio and SPM. Results The glucose metabolism ratio improved more in the LIPC group than in the control group（P〈0.01）, and aggravated less than in the control group（P〈0.001）. As setting the glucose metabolism increased after treatment, there were 7 areas activated in LIPC group, including frontal, temporal and parietal lobes, and the KE=1121; while there were 5 areas activated in the control group, including frontal and parietal lobes, and the KE=292. As setting the glucose metabolism decreased after treatment, there was only frontal area activated in LIPC group, while there were 8 areas activated in the control group, including frontal, parietal, occipital lobes, and the KE=629. Conclusion LIPC may improve the brain glucose metabolism in patients with moyamoya disease, which can be observed with PET and SPM.