针刺激增即时SPECT脑显像识别脑血管病存活脑组织研究.docVIP

针刺激增即时SPECT脑显像识别脑血管病存活脑组织研究 (潍坊市人民医院,山东261041) 　　[摘 要] 目的:观察电针刺激增即时单光子发射计算机断层(SPECT)脑显像显示出的放射性填充病灶(RFA)与临床神经功能的相关关系,为判定存活脑组织(SCT)提供依据。? 　　方法:测定双侧腧穴电针刺激增后99mTc?ECD?SPECT脑显像的RFA的容积激增率(RIV)。然后进行以电针刺为主的综合性治疗,按治疗前后神经功能缺损积分变化,计算神经功能恢复率(RNR)。? 　　结果:37例患者的RNR18%,其RIV与RNR之间呈显著正相关关系(r=0?631,P0?01);有35例42处RFA与恢复的神经功能之间存在定量、定位关系,被判定为SCT阳性。该技术识别SCT的敏感性为94?59%,特异性为70?00%,阳性预测值为83?33%。? 　　结论:电针刺可即时激增RFA区域SCT的兴奋性,增加其对99mTc?ECD的摄取。针刺后二次SPECT脑显像可定性、定位、定量显示CVD患者脑内散在的SCT。? 　　[主题词] 存活脑组织?;脑血管意外/针灸疗法;体层摄影术,发射型计算机,单光子StudyonSurvivalCerebralTissueDetectedbySPECTafterElectroacupunctureinC erebralVascularDiseasesGuoSongpeng,LuJianping,HanXiaoling,etal(WeifangMunicipalPeople′sHospital,Shandong261041) 　　[Abstract] Purpose Toobservetheralationshipbetweentheelectroacupuncture?inducedincreaseofvolumeofradioac?tivity?filledarea(RFA)detectedbySPECTandclinicalneurofunctionsincerebrovasculardisease(CVD)todeterminethesurvivalcerebraltissue(SCT).Methods Fourty?sevencasesofCVDwereselectedrandomly.Therateofimprovementofvolume(RIV)ofRFAafterelectroacupunctureatacupointsofbothsideswasdeterminedwiththedoub letomographyof99mTc?ECD?SPECT.Allpatientshadbeentreatedwithcomprehensivetherapyfor20daysafterSPECT.The rateofneurofunctionrecovery(RNR)wasmeasuuedonthebaseofneurofunctiondeficitscores.Results Therewaspositivecor?relationbetweenRIVandRNRinthirty?sevenpatientswhoseRNRwasmorethan18%(r=0?631,P0?01).Accord?ingtothelocationstansardofcerebralneurofunction,therelationshipbetweenpositi onandneurofunction(hadrecovered)offourty?twopatients(35RFAs)wasdetermined.TheseRFAswereconfirmedaspositiveSCTandlocatedaroundra?dioactivelackareas(RLA),ormixwithRLA,orawayfromRLA.Twopatients(3RFAs)wereregardedasfalsenegativeSCT,five(6RFAs)asfalsepositiveandfiveasnegative.Conclusion Electroacupuncturecanimmediatelyenhancethecerebralexcitablityandincrease theabilityofcerebrumtissueuptaking99mTc?ECD.ThesecondSPECTafterelec?troacupuncturecanshowthelocation,quantityandnatureofSCTinthebrainofthepatien tofCVD.? 　　[Keywords] Surviv