CT灌注成像结合血浆谷氨酸、γ-氨基丁酸检测对诊断急性脑梗死的价值  

CT perfusion imaging and determination of Glu and GABA content in acute cerebral infarction

作　　者：满晓[1] 冷振璞[1] 庞在英[1] 杜怡峰[1] 

机构地区：[1]山东大学附属省立医院神经内科,济南250021

出　　处：《山东大学学报（医学版）》2008年第8期784-786,790,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨CT灌注成像(CTPI)结合检测血浆谷氨酸(Glu)、γ-氨基丁酸(GABA)水平在诊断急性脑梗死及判断脑梗死体积中的应用价值。方法对57例发病24h内的脑梗死患者行头颅CT平扫与CTPI检查,计算梗塞区相对脑血流量(rCBF)、平均通过时间(MTT)、峰值时间(TP);应用高效液相色谱法测定所有患者的血浆Glu、GABA水平。结果普通CT平扫显示低密度灶者26例,均为责任病灶,未见异常者31例。CTPI显示灌注异常者54例,均为责任病灶,灌注正常者3例;CTPI显示患者rCBF、TP、MTT显著改变,病灶侧与对侧、病灶中心区与周边区比较,差异有统计学意义(P<0.05)。直线相关分析表明,血浆Glu、GABA水平与脑梗死体积呈正相关(r=0.88,P<0.01;r=0.47,P<0.01)。结论CTPI结合检测血浆Glu、GABA水平变化,可以超早期诊断脑梗死并能有效判断梗死体积,有助于判断预后和制定治疗方案。Objective To investigate the application of computed tomography perfusion imaging（ CTPI）combined with determination of Glu and GABA in the plasma in diagnosis of acute cerebral infarction （CI）, Methods 57 patients with acute cerebral infarction onset within 24 hours were examined by conventional CT and CTPI. CTPI yielded a set of relative cerebral blood flow （rCBF）, mean transmit time（MTT） and time to peak（TP）. By mean of high-performance liquid chromatography, the levels of GIn and GABA in the plasma of all patients were determined. Results Conventional CT scan showed a low-density signal in 26 of 57 patients. CTPI revealed normal peffusion in 3 patients and hypo-perfusion in 54 patients. The regional cerebral blood flow （rCBF）, time to peak（TP）, and mean transit time（MTT）were obviously changed in 54 patients by CTPI. The ischemie lesion side as compared with the opposite side, and the core of the ischemic lesion as compared with the peripheral zone were signifi- cantly changed（ P 〈0.05）. A linear correlation analysis showed that there were positive correlations between infarction volume and plasma levels of Glu and GABA （ r = 0.88, P 〈 0.01 ; r = 0.47, P 〈 0.01） and the infarction volume. Conclusion CTPI combined with determination of Glu and GABA in plasma can be used in diagnosis of early stage of cerebral infarction and measurement of infarct volume, so it is great for prognosis and treatment.

关 键 词：脑梗死 体层摄影术 X线计算机 谷氨酸 Γ-氨基丁酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]