惊恐障碍局部脑血流灌注的研究

目的 探讨惊恐障碍（ＰＤ）与局部脑血流改变的关系及其可能的生物学机制。方法对１６例ＰＤ患者及１５名正常对照者应用单光子发射计算机断层摄影技术测定ｒＣＢＦ灌注。结果 ＰＤ患者ｒＣＢＦ灌注异常的阳率为１００％，低灌注我见地双侧前下额叶和下颞叶、右侧枕叶及左侧基底节；其中双侧额叶、右侧颞叶及在工基底节的ｒＣＢＦ降低民Ｈａｍｉｌｔｏｎ焦虑量表评分呈直线负相关，结论 提示皮层－纹状体神经环路在ＰＤ的神经病理     

精神分裂症的阴性症状与额叶功能障碍

目的：探讨精神分裂症阴性症状与额叶功能的关系。方法：应用９９ｍＴＣ－乙撑双半胱氨酸二乙酯ＳＰＥＣＴ技术，以范畴测验为心理作业任务，测量９例高阴性症状与１３例低阴性症状的精神分裂症患者静息状态与心理作业时的局部脑血流（ｒＣＢＦ），并与１０例正常对照组比较。结果：静息状态时，阴性症状与左下额叶ｒＣＢＦ呈显著负相关，低阴性组左下额叶血流灌注增高。心理作业时，阴性症状与右上额叶ｒＣＢＦ呈显著负相关，高阴性组右上额叶血流灌注低于低阴性组。两病例组左、右额叶ｒＣＢＦ均低于正常对照组。结论：精神分裂症阴性症状可能与左下额叶及右上额叶功能障碍有关     

注意缺陷多动障碍患儿局部脑血流灌注的研究

为探讨注意缺陷多动障碍（ＡＤＨＤ）局部脑血流（ｒＣＢＦ）特点及其可能的病理生理机制，应用单光子发射计算机断层扫描测定了１７例ＡＤＨＤ患儿和１１名正常儿童ｒＣＢＦ灌注情况。定性分析结果显示，ＡＤＨＤ患儿低ｒＣＢＦ灌注量的发生率（３５％）高于正常儿童（９％），低灌注部位涉及额叶、颞叶、枕叶和丘脑；半定量分析显示，左基底节灌注明显低于右侧（Ｐ＜０．０１），右侧扣带回和颞叶灌注低于左侧相应部位（Ｐ＜０．０５）。提示额叶－基底神经节环路在ＡＤＨＤ的病理生理机制中起重要作用。     

高压氧对脑梗塞患者SOD,MDA与rCBF的影响

检测２０例脑梗塞患者高压氧（ＨＢＯ）治疗前后自由基水平与ｒＣＢＦ的变化，并与健康对照组相比较。结果患者组自由基水平显著增高，ＳＯＤ活性降低，ｒＣＢＦ明显下降。患者组ＨＢＯ后与ＨＢＯ前比较ＳＯＤ活性显著增高，ＭＤＡ与ｒＣＢＦ均下降。说明ＨＢＯ对脑梗塞患者存在的自由基损害有显著疗效     

抑郁症患者的脑单光子发射计算机断层摄影研究

为观察抑郁症患者局部脑血流（ｒＣＢＦ）情况，对１１例处于症状发作期的抑郁症患者及１３名正常对照者用９９ｍＴｃ标记的亚锡双半胱乙脂进行脑单光子发射电子计算机断层摄影（ＳＰＥＣＴ）。结果显示，观察组与对照组比较，左下额、左前颞及扣带皮质的ｒＣＢＦ显著下降（Ｐ＜０．０１），而右上额、右下额和两侧顶叶、枕叶的ｒＣＢＦ也有下降（Ｐ＜０．０５）。观察组尚存在上额皮质ｒＣＢＦ两侧非对称性（Ｐ＜０．０５），而对照组未见相应的非对称性。提示抑郁症发作时存在某些脑功能区ｒＣＢＦ下降以及两侧脑功能区局部的ｒＣＢＦ不对称性。     

脑梗塞患者局部脑血流与红细胞膜微粘度关系的研究

检测了５３例脑梗塞患者及３０例健康对照者的局部脑血流（ｒＣＢＦ）和红细胞膜微粘度（ＥＭ－ＭＶ）。结果显示：患者组患侧半球ｒＣＢＦ与健康组同侧半球比较有极显著性差异（Ｐ＜０．００１）。患者组ＥＭＭＶ与健康对照组比较，明显高于对照组（Ｐ＜０．０１）。ＥＭＭＶ与ｒＣＢＦ呈反比，血液粘度越高，对血流切变应力影响越大，脑血流量越低。提示血液流变学的改变是影响脑血流的重要因素，故降低红细胞膜微粘度，对于改善脑血流量，预防和治疗脑梗塞是十分重要的。     

脑缺血性学习记忆障碍小鼠rCBF变化及药物影响

目的研究脑缺血性学习记忆障碍小鼠额叶皮层、海马区不同时间局部脑血流（ｒＣＢＦ）变化及药物防护作用。方法通过电解式氢清除法对脑缺血所致学习记忆障碍小鼠不同区域、不同时间进行ｒＣＢＦ测定。结果脑缺血急性期、再灌注期ｒＣＢＦ明显减少,与正常对照组比较有显著性差异（Ｐ＜０．０５）。结论适当的药物治疗可改善相关部位ｒＣＢＦ,从而提高小鼠学习记忆能力。     

脑卒中患者局部脑血流量与红细胞膜微粘度的研究

本文采用１３３Ｘｅ吸入法检测５３例脑卒中患者及３０例健康对照组的局部脑血流（ｒＣＢＦ），同时检测红细胞膜微粘度（ＥＭＭＶ）。结果患者组患侧半球ｒＣＢＦ与健康对照组同侧半球比较有极显著性差异（Ｐ＜０．００１）。患者组ＥＭＭＶ明显高于健康对照组（Ｐ＜０．０１）。提示：血液流变学的改变是影响脑血流的重要因素。ＥＭＭＶ与ｒＣＢＦ呈负相关，故改善红细胞膜微粘度，对提高脑血流量，预防和治疗脑梗塞是十分重要的。     

急性创伤性脑损伤动物模型早期局部脑血流量变化的实验研究

为了研究急性创伤性脑损伤早期局部脑血流量（ｒＣＢＦ）的变化，作者制作了闭合性机械脑损伤动物模型，采用氢清除法测定ｒＣＢＦ。结果显示脑损伤后早期ｒＣＢＦ即明显减少（Ｐ＜０．０５），伤后６～１２ｈ内下降最为明显，脑损伤的严重程度和ｒＣＢＦ下降程度呈显著正相关；皮质ｒＣＢＦ下降幅度大于白质。提示ｒＣＢＦ的变化反应了脑损伤的程度。作者认为ｒＣＢＦ降低是导致继发性脑损伤进行性加重的重要原因。     

Alzheimer病大鼠局部脑血流量与行为学改变的研究

目的 研究Ａｌｚｈｅｉｍｅｒ病大鼠的局部脑血流量及学习记忆的改变及尼莫地平对其影响。方法β－淀粉样蛋白注入大鼠迈特基底核建立大鼠ＡＤ模型，氢清除法动态观察海马，额叶局部脑血流量，三等分Ｙ迷宫测定大鼠学习记忆能力。治疗组大鼠腹腔注射尼莫地平至实验结束。结果 实验组大鼠额叶和海马的ｒＣＢＦ的下降，学习记忆能力下降；治疗组ｒＣＢＦ均有改善，至第２周接近注射前；但与对照组比较仍有差异。β－ＡＰ注入ＮＢＭ能     

The effects of clozapine on cognitive function and regional cerebral blood flow in the negative symptom profile schizophrenia

OBJECTIVE: Cognitive function and regional cerebral blood flow (rCBF) were studied in negative symptom profile schizophrenic patients by using WCST and SPECT. METHODS: Twenty-one schizophrenic patients who matched the criteria of Andreason's negative symptom profile received SPECT and WCST, and then were treated with clozapine for 8 consecutive weeks. There were 28 and 12 normal subjects as the control groups of WCST and SPECT, respectively. RESULTS: Compared with controls, significantly poorer performance on total trials of category (TT), persevering errors (PE), and non-persevering errors (NPE) of WCST were found in schizophrenia (p < 0.05). The total score of the scale for assessment negative symptoms (SANS) was significantly related with poor TT (r = 0.45, p < 0.01) and PE performance (r = 0.45, p < 0.01). The poor TT, PE, and NPE tasks of WCST and SANS scores in the negative schizophrenic patients were significantly improved through clozapine treatment (p < 0.05). The schizophrenic patients had a significantly lower rCBF in bilateral frontal and temporal lobes and lower change rate of rCBF in bilateral frontal lobes during WCST compared to normal controls (p < 0.05). CONCLUSIONS: Negative symptom profile schizophrenia has cognitive deficits and lower rCBF in bilateral frontal and temporal lobes, which suggests that negative symptom profile schizophrenic patients have hypofrontality. Clozapine can improve negative symptoms and improve cognitive dysfunction, although it cannot improve reduced rCBF in the frontal lobes.     

Recovery from aphasia and cerebral blood flow: a comparison between cerebral hemorrhage and cerebral thrombosis

To compare cerebral circulation in aphasic patients who had cerebral hemorrhage against those who with cerebral thrombosis, we studies 50 patients with hypertensive intracranial (putaminal) hemorrhage and 20 patients with cerebral thrombosis whose diagnoses were confirmed on repeated CT scan and cerebral angiography. The measurements of regional cerebral blood flow (rCBF) by the 133Xe intraarterial injection method was carried out in 40 patients. The evolution of the aphasic syndrome was analyzed according to Hirano's classification and the patients were divided into two groups: those having a favorable recovery from aphasia; those with a poor recovery. Twelve out of 20 patients with cerebral hemorrhage showed a favorable recovery from aphasia, whose left hemispheric mean blood flow (mCBF) was 33.1 +/- 9.7 ml/100 g/min. The mCBF was 30.8 +/- 10.3 ml/100 g/min in 8 patients with a poor recovery. There was no significant difference in mCBF values between the two groups. The favorable recovery group showed slightly higher regional values in the left frontal and temporal lobes than did the poor recovery group, but no significant difference was found between the two group. Here, rCBF values failed to correlate between the two kinds of recovery from aphasia in patients with cerebral hemorrhage. The marked variability in rCBF values in the acute stage might partly account for the poor correlation in cerebral hemorrhage. In contrast, a series of rCBF studies demonstrated that rCBF values stabilized in the acute and subacute stage in cerebral thrombosis. Nine out of 20 patients with cerebral thrombosis had a favorable recovery from aphasia.(ABSTRACT TRUNCATED AT 250 WORDS)     

精神分裂症患者局部脑血流研究

目的：了解精神分裂症患者局部脑血流(rCBF)特征，探讨rCBF与临床症状和疗效的关系。方法：采用阳性症状与阴性症状量表(PANSS)评定精神分裂症患者精神症状，应用^99m锝-双半胱乙脂(^99mTc-ECD)，单光子发射计算机断层扫描(SPECT)技术，测量患者治疗前后rCBF，并与11名正常人作对照。结果：治疗前患者组右侧额叶与右侧颞叶rCBF低于对照组；治疗后右侧额叶与右侧颞叶rCBF较治疗前明显增加。治疗前不同脑区rCBF与精神病理症状和疗效均无显著相关。结论：精神分裂症患者存在右侧额叶与颞叶局部脑功能减退，但未发现rCBF与精神病理症状和疗效有关。     

SPECT检测精神分裂症病人的局部脑血流研究

目的了解精神分裂症病人的局部脑血流特征,探讨局部脑血流与精神病临床症状和疗效的关系.方法采用PANSS量表评定患者的精神症状,应用99m TC-ECD-SPECT技术,对17例从未接受过抗精神病药物治疗的精神分裂症病人,在接受治疗前与治疗后测量局部脑血流,并与11例正常对照组比较.结果治疗前病例组右侧额叶与右侧颞叶rCBF低于对照组(各P<0.05),治疗后右侧额叶与右侧颞叶rCBF较治疗前明显增加(各P<0.05);治疗前不同脑区rCBF与精神病理症状(含单个症状评分和因子分)和疗效均无显著性相关.结论结果提示精神分裂病人存在右侧额叶与右侧颞叶局部脑功能减退,但未发现局部脑血流与精神病理症状和疗效有关.     

Reduced regional cerebral blood flow in non-psychotic violent offenders

The present study was designed to replicate previously reported findings of abnormal frontal and/or temporal cerebral blood flow in violent offenders and to control for the influence of major mental disorder (MMD), substance abuse, and current medication. HMPAO-SPECT-CBF and MRI scans from pretrial forensic psychiatric investigations of 21 subjects convicted of impulsive violent crimes were retrospectively re-evaluated. In 16/21 subjects, visual assessment of SPECT scans showed some hypoperfusion in the temporal and/or frontal lobes. MRI showed no corresponding structural damage. Quantified regional cerebral blood flow (rCBF) in defined regions of interest was compared between index cases and 11 healthy control subjects. Index subjects had significant reductions in the right angular gyrus and the right medial temporal gyrus, bilaterally in the hippocampus, and in the left white frontal matter, but they had significantly increased rCBF in the parietal association cortex bilaterally. The aberrations were as frequent and severe among the subjects without MMD, substance abuse, and current medication (n=7) as in the entire group of index subjects.     

抑郁症患者局部脑血流的研究

目的：了解抑郁症患者局部脑血流灌注的特点：方法：应用单光子发射计算机断层扫描对20例抑郁症患者及18例正常对照者局部脑血流灌注进行对比分析。结果：抑郁症组双侧基底核、双侧额叶、左颞叶及左枕叶局部血流低灌注；抑郁症组与对照组左右大脑半球局部血流灌注无显著性差异：结论：抑郁症患者局部脑血流存在低灌注，但未发现局部脑血流低灌注有侧化现象。     

The investigation of Alzheimer''s disease with single photon emission tomography.

Twenty patients satisfying standard clinical criteria for Alzheimer's disease (AD) and six age-matched normal controls were studied using 99mTc hexamethyl-propyleneamine oxime and single photon emission tomography. The AD patients had lower regional cerebral blood flow (rCBF) in the temporal and posterior parietal lobes compared to controls. AD patients with apraxia and aphasia had lower rCBF in the lateral temporal and posterior parietal lobes than AD patients without these features. Within the AD group, correlations were found between neuropsychological tests and rCBF: praxis correlated with posterior parietal activity, memory with left temporal lobe activity and language with activity throughout the left hemisphere.     

Focal reductions of cerebral blood flow in amyotrophic lateral sclerosis: a [99mTc]-d,l-HMPAO SPECT study.

We investigated regional cerebral blood flow (rCBF) using the [99mTc]-d,l-HMPAO technique with brain dedicated high resolution single photon emission computer tomography (SPECT) in 14 consecutive patients with amyotrophic lateral sclerosis (ALS), median age 62 years (45-77). Global CBF, expressed in % relative to the cerebellum, was significantly lower (P less than 0.05) in the ALS group (80.5 +/- 6.7%) than in the control group of 14 age-matched healthy volunteers (87.0 +/- 7.5%). Eight patients (57%) had abnormal rCBF distribution maps with reduced flow, primarily in the frontal lobes. Three of the 8 patients with abnormal rCBF had mild to moderate dementia and another one had mild aphasia. None of the patients with normal rCBF distribution maps had dementia. In the group of ALS patients as a whole rCBF was significantly reduced in the frontal cortex, the hippocampus, and the central white matter. We conclude that reduced rCBF, primarily in the frontal lobes, is a frequent finding in patients with ALS. The decreased rCBF may be associated with cognitive deficits and is most likely caused by neuronal degeneration and reduced metabolic needs.     

大脑静息葡萄糖代谢改变与情绪障碍的相关性

目的前瞻性分析大脑静息葡萄糖代谢改变在初诊肺癌患者情绪障碍发病中的临床意义。方法实验组来自临床拟诊肺癌并拟行全身(脑+躯干)18F-氟脱氧葡萄糖(18F-FDG)正电子发射断层显像/计算机体层摄影(PET/CT)检查的患者,对照组来自健康体格检查者。所有被试者在18F-FDG PET/CT检查前接受哈密尔顿抑郁量表(HAMD)及焦虑量表(MAS)评定,对比分析大脑静息葡萄糖代谢改变、情绪障碍评分以及两者之间的相关性。结果最终纳入155例肺癌患者(实验组)及152例健康体检者(对照组),实验组HAMD评分及MAS评分均高于对照组(t=1.020.P=0.04;t=0.09,P=0.03);实验组脑PET显像存在以双侧额、颞叶为主的多个脑区葡萄糖代谢减低,且受累脑区平均标准化摄取值(SUV)在双侧额叶及左侧颞叶分别与HAMD评分呈负相关(r=0.68、0.60、0.55),在左侧额叶及左侧颞叶分别与MAS评分呈负相关(r=0.59、0.58)。结论大脑静息葡萄糖代谢改变与情绪障碍在肺癌患者中具有显著相关性,且以额叶为著。脑葡萄糖代谢改变可能是肺癌患者情绪障碍发病的神经病理基础,有望作为神经生物学标记用于临床评估。     

SPECT检测利培酮对精神分裂症患者脑血流灌注的影响

目的探讨利培酮对局部脑血流灌注(rCBF)的影响及疗效与rCBF之间的关系。方法研究组为24例未用过药的精神分裂症患者。男10例,女14例。正常对照组26例,男12例,女14例。用利培酮(3～6mg/d)治疗8周。患者在治疗前后进行基础状态及认知激活状态脑SPECT显像。结果与正常对照组相比,治疗前基础状态时,24例患者左右颞叶后下部血流灌注增加;激活状态时,左额叶外侧中部血流灌注显著下降。治疗后与治疗前相比,右颞叶外侧部、左右颞叶后上部基础状态的血流灌注显著下降;左右额叶中下部、左额叶外侧下部、左额颞上部及左额外侧上部认知激活状态的血流灌注显著增加。PANSS减分率与脑血流灌注的变化有关。结论利培酮治疗精神分裂症后,右颞外侧部、左右颞叶后上部、左右额叶中下部及左额叶外侧上下部的血流灌注变化显著。疗效与血流灌注变化有关。提示脑血流灌注对预测药物疗效具有重要意义。