安氟醚麻醉下健康志愿者脑葡萄糖代谢的显像研究  

A positron emission tomography study on the effect of enflurane inhalation on human cerebral glucose metabolism

作　　者：于代华[1] 徐礼鲜 柴伟[1] 张惠 林树新[3] 徐海峰[4] 

机构地区：[1]第四军医大学唐都医院麻醉科,西安市710038 [2]第四军医大学口腔医院麻醉科 [3]第四军医大学基础部病理生理学教研室 [4]第四军医大学唐都医院核医学科,西安市710038

出　　处：《临床麻醉学杂志》2006年第1期1-3,共3页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金资助项目(30271257)

摘　　要：目的应用正电子发射断层扫描技术(positronemissiontomography,PET),研究健康志愿者吸入不同浓度安氟醚麻醉时脑葡萄糖代谢(CMGlu)的改变。方法选择5名志愿者,每位志愿者分别做3次PET扫描,采用PHILIPSCPETPlus扫描仪及18氟标记的脱氧葡萄糖(18FDG)标记技术测定CMGlu,第1次在清醒状态下扫描作为对照,第2、3次分别吸入0.5MAC和1.0MAC安氟醚。结果与清醒时比较,吸入0.5MAC和1.0MAC安氟醚后全脑CMGlu显著降低(P<0.05,P<0.01)。吸入0.5MAC安氟醚麻醉后脑内各区CMGlu计数均显著降低(P<0.05),但以丘脑、扣带回、额叶、楔叶、楔前叶和桥脑更为显著(P<0.01);与0.5MAC时比较,1.0MAC时全脑及脑内各区CMGlu计数均进一步降低(P<0.05),但程度基本一致。结论全脑及脑内各区CMGlu在吸入安氟醚麻醉时均可显著降低,且程度与吸入安氟醚的浓度似乎相关。丘脑、扣带回、额叶、楔叶、楔前叶和桥脑等脑区对安氟醚更为敏感。Objective To investigate the effects of enflurane inhalation at different concentrations on cerebral glucose metabolism （CMGlu） in healthy volunteers. Methods Each of five volunteers received three PET （PHILIPS CPET Plus scanner using the ^18fluorodeoxyglucose technique） scans：during awake, 0.5 MAC and 1.0 MAC enflurane inhalation. Results Compared with awake state, enflurane anesthesia decreased whole-brain CMGlu significantly at 0.5 MAC and 1.0 MAC level （P〈0.05, P〈0.01）, regional CMGlu also decreased throughout the brain at 0.5 MAC level, espe cially in the thalamus, cingulate gyrus, frontal lobe, cuneus, precuneus and pons （ P〈0.01 ）. Compared with that at 0.5 MAC level, regional CMGlu decreased significantly but uniformly at 1.0 MAC level （P〈0.05）. Conclusion Whole-brain and regional metabolism decreases significantly during enflurane anesthesia, which seems to be related to enflurane concentration. The thalamus, cingulate gyrus, frontal lobe,cuneus, precuneus and pons were the most sensitive to enflurane.

关 键 词：安氟醚 ^18氟脱氧葡萄糖 正电子发射断层扫描 脑代谢率 葡萄糖 

分 类 号：R614[医药卫生—麻醉学]