癫痫患者SPECT异常灌注灶在药物长期控制前后动态变化的临床研究  

Dynamic changes of abnormal perfusion foci on SPECT in patients with epilepsy before and after long-term control of epilepsy with antiepileptic drugs

作　　者：王为民[1] 王天成[1] 陈雪红[2] 冯忠聘[2] 叶江[1] 罗福明[1] 

机构地区：[1]兰州大学第二医院神经内科/癫痫中心,甘肃省兰州市730030 [2]兰州大学第二医院核医学科,甘肃省兰州市730030

出　　处：《国际神经病学神经外科学杂志》2009年第2期95-97,共3页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨癫痫患者在药物长期控制前后SPECT异常灌注灶的动态变化。方法对77例癫痫患者药物治疗前后检查发作间期SPECT和长程EEG并对其结果进行对比分析。结果SPECT显像示异常灌注灶治疗前后无变化者占39.0%,有变化者占61.0%。治疗前异常灌注灶123个,治疗后71个,治疗前后总变化52个(42.2%)。治疗后SPECT扫描正常14例(18.2%),较治疗前的5例(6.5%)增加。长程EEG治疗前后改变36.6%(26/71),痫性放电消失42.6%。SPECT异常灌注灶动态变化模式有5种:低/高灌注灶转化为高/低灌注灶;正常转化为低/高灌注灶或相反;单灶转化为多灶或相反;高-低灌注灶同时存在;发作期间的高灌注。结论抗癫痫药物长期控制后SPECT异常灌注灶的动态变化模式为5种,对于认识癫痫的复发和治疗有重要意义。Objective To study the dynamic changes of abnormal perfusion foci on SPECT in patients with epilepsy before and after long-term control of epilepsy with antiepileptic drugs. Methods The interictal SPECT and long-term EEG were performed before and after treatment in 77 patients with epilepsy. Results Sixty-one percent of patients demonstrated changes in the SPECT imaging before and after treatment. The number of abnormal perfusion foci before and after was 123 and 71, respectively. Fifty-two （42.3%） out of the 123 abnormal perfusion foci showed changes after treatment. After treatment 18.2% of patients showed normal on SPECT and the proportion increased compared with before treatment （6.4%）. Twenty-six patients （36.6%） demonstrated EEG changes after treatment. Epileptic discharges disappeared in 23 patients （42.6%）. Five models of dynamic changes of abnormal SPECT perfusion foci were found ： hypoperfusion foci was transformed to hypertransfusion foei or the opposite changes ; normal SPECT imaging was transformed to hypoperfusion or hypertransfusion foci or the opposite changes ; single foci was transformed to multiple foci or the opposite changes ; both hypertransfusion and hypoperfusion foci occurred; interictal hypertransfusion. Conclusions There were five models of dynamic changes of abnormal perfusion foci on SPECT in patients with epilepsy after long-term control of epilepsy with antiepileptic drugs.

关 键 词：癫痫 抗癫痫药物 控制 异常灌注灶 动态变化 

分 类 号：R742.1[医药卫生—神经病学与精神病学]