皮质下梗塞所致失语的SPECT显像研究  

Clinical study on SPECT imaging in subcortical aphasia

作　　者：陆相东[1] 冯惠茹[1] 李亚明[2] 孔繁振[1] 遇彬[1] 于杨杰[1] 于芳[1] 解小芬[1] 

机构地区：[1]北京军区总医院核医学科,北京100700 [2]中国医科大学附属第一医院核医学科,辽宁沈阳110001

出　　处：《生物医学工程与临床》2006年第6期350-352,共3页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨皮质下梗塞所致失语的发生与脑血流改变的部位、范围及程度间的关系。方法对37例临床确诊为单侧皮质下梗塞的患者行SPECT局部脑血流显像,判定局部脑血流(rCBF)改变的部位、范围及程度,并按北京大学人民医院汉语成套测验(aphasiabatteryofChinese,ABC)进行检测。结果30例有失语表现,SPECT显像示患者的rCBF降低部位多位于基底节区前部、上部、外侧部及丘脑。皮质下失语的患者rCBF降低部位多累及大脑皮质语言功能区﹙χ2=8.87,P<0.005雪。病灶区的rCBF及rCBF降低的百分比与失语程度的相关系数分别为-0.41(t=-1.59,P>0.05)和0.64(t=2.71,P<0.05);病灶的范围、病灶数与失语程度之间的相关系数分别为0.79(t=3.81,P<0.01)和0.67(t=3.16,P<0.01)。结论皮质下梗塞所致失语患者rCBF降低部位多累及大脑皮质语言功能区;病灶区的rCBF与失语程度的相关性较小,而病灶的rCBF降低的百分比、病灶范围、病灶数与失语程度呈正相关。Objective To explore the relationships between the occurrence, severity of subcortical aphasia and the region, range or extent of regional cerebral blood flow （rCBF） decreasing. Methods Thirty- seven patients definitly diagnosed as unilateral subcortical infarction and aphasia were performed SPECT rCBF imaging. All of patients were detected by aphasia battery of Chinese（ABC）. Results There were 30 patients with subcortial aphasia. On SPECT imagings, there were lesions in lateral, front and upper part of basal ganglion in the patients with subcortical aphasia. The patients with damaging in two or more regions suffered aphasia more easily. The correlation coefficients between rCBF and the decreasing percentage of rCBF and the severity of aphasia were - 0.41 （t = - 1.59, P 〉 0.05） and 0.64 （t = 2.71, P 〈 0.05 ）, respectively. The correlation coefficients between the deficit range, number of foci and the severity of aphasia were 0.79 （t = 3.81 ,P 〈 0.01 ）and 0.67 （t = 3.16, P 〈 0.01 ）, respectively. The subcortical aphasia was positively correlated with the decrease of cortical rCBF significantly （ X^2 = 8.87,P 〈 0.005）. Conclusion The severity of aphasia correlates with rCBF insignificantly,while it correlates with the decreasing percentage of rCBF and the deficit range as well as the number of foci significantly. The subcortical aphasia is positively correlated with the decrease of cortical rCBF. Subcortical damaging of multiple sites will result in more severe aphasia.

关 键 词：皮质下梗塞 失语 单光子发射型计算机体层摄影术 局部脑血流 

分 类 号：R743.33[医药卫生—神经病学与精神病学]