额叶皮质灌注不足的纯构音障碍  

Pure dysarthria due to frontal cortical hypoperfusion

作　　者：王丽敏[1] 周筠译[1] 张玉梅[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,北京市075000

出　　处：《中国组织工程研究与临床康复》2007年第16期3112-3115,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察纯构音障碍患者病变部位及脑血流量的变化。方法:选择1988-06/1997-02在日本Hyogo医科大学第十五医院收治的12例右利手纯构音障碍患者。纳入标准:均符合构音障碍主要特点,包括发音不清、慢,低音韵律,且没有其他神经受累,如伴随其他神经症状也为轻度,如面部肌肉受累、舌肌受累,无口语听理解和书写能力障碍。年龄49～81岁,平均(65±13)岁,其中男10例,女2例。选择11名CT或MRI显示无脑损伤同期入院健康体检健康者作为对照组,平均(68±11)岁。所有纳入受试对象均对检测项目知情同意。①对病例组患者进行头部MRI检查,确定脑梗死部位。②对两组受试对象进行局部脑血流量检测,局部脑血流量半量值按以下方法计算:选取4×4象素的兴趣区(ROI),定量分析脑区摄取的123I-IMP。参考脑功能定位图谱,检查15mm×15mm×7.5mm大小的脑体积所对应的28个标准化位置,包括前额叶2个(中、侧面)、前盖部1个、前环部1个、前中运动区1个,感觉运动区2个(上部、下部)、顶叶2个(上、后)、颞叶3个(上、中、下)、枕叶1个、小脑1个,均选择左右两侧。每1区域的吸收由此区的每象素的平均数来确定。测量每个区域的吸收率[吸收率=2×(垂直棒)左-(垂直棒)右/L+R]。结果:纳入12例患者和11名健康对照者全部进入结果分析。①病例组患者MRI检查结果:11例患者为两侧多发腔隙梗死,1例为单侧内囊-放射冠梗死。所有患者病变部位均在内囊或放射冠(3例为单侧、9例为双侧)受累。8例为内囊梗死,其中6例为后肢损伤、3例为膝部、1例在前肢。9例有放射冠梗死(3例在前部、2例在后部、4例前后部均受累),3例为桥脑梗死,1例为丘脑梗死,1例为基底节梗死。10例在T2加权MRI上显示脑室周围高信号。②病例组患者脑血流量检测结果:8例患者前额叶皮质呈低灌注状态,其中1例患者主要在旁矢状面和前盖区AIM： To investigate lesion sites and cerebral blood flow （CBF） in patients with pure dysarthna （PD）. METHODS： Twelve right-handed patients with PD were enrolled from the Fifteenth Hospital of Hyogo College of Medicine between June 1988 and February 1997. Inclusive cnteda： The main characteristics of dysarthfia were slurred, indistinct articulation with slow, low-pitched prosody, and without other nerve involvement, additionally mild neural symptoms, such as facial muscular involvement, lingual muscular involvement, comprehension of spoken language and ability of writing were intact. The patients aged 49-81 years and a mean of （65±13） years, including 10 males and 2 females. Eleven healthy subjects of mean age （68±11） years, who had no brain lesions on CT or MRI, were taken as controls. Wntten informed consent was obtained from the control subjects as well as the patients before this study.（1）All the patients were underwent MRI measurement for the lesion of cerebral infarction. （2）Both groups were adopted for regional CBF （rCBF）, and semiquantitative rCBF values were computed as follows： ^123I-IMP uptaking in individual brain areas was quantified by visually placing regular 4×4 pixel regions of interest （ROI）, corresponding to 15 mm×15 mm× 7.5 mm brain volumes on 28 standardized positions. These consisted of the following numbers of ROIs on each brain region： prefrontal, 2 （medial, lateral）; anterior operculum, 1, anterior cingulate, 1; medial premotor, 1; sensorimotor, 2 （superior, inferior）; parietal, 2 （superior, posterior）; temporal, 3 （superior, middle, inferior）; occipital, 1; and cerebellum, 1; all bilaterally. Uptake in each region was defined as the mean count per pixel in that region. The ratio of uptake in each region was measured according to the formula of 2×（vertical bar）L-（vertical bar）R/（L＋R）. RESULTS： Both 12 patients and 11 controls were involved in the result analysis.（1）MRI examination of patients： Eleven

关 键 词：构音障碍 额叶皮质 血流灌注 

分 类 号：R332.8[医药卫生—人体生理学]