脑卒中针刺康复的扩散张量成像分析  

Diffusion Tensor Imaging Analysis of Acupuncture Therapy in Cerebral Infarction

作　　者：毕玉堂 申云霞[2] 李明[3] 魏瑞鹏[3] 陈蕾[2] 娄明武[2] 

机构地区：[1]深圳市龙岗区南澳人民医院超声科,广东深圳518121 [2]深圳市龙岗中心医院介入影像科 [3]深圳市龙岗中心医院神经内科

出　　处：《实用放射学杂志》2010年第7期926-929,共4页Journal of Practical Radiology

基　　金：深圳市科技局基金资助项目（编号：20092163）.

摘　　要：目的 应用扩散张量成像（DTI）技术观察针灸对脑卒中治疗的疗效.方法 选取健康志愿者30例,男17例,女13例,年龄19～62岁,平均55岁;急性脑卒中致偏瘫患者20例,随机分为针灸组与非针灸组各10例.2组患者西医治疗情况一致,针灸组于超急性期行石氏醒脑开窍法针灸治疗.实验者均为右利手,行常规T2WI、FLAIR及DTI扫描,连续追踪复查8周,每周1次,分析梗死病灶ADC值与FA值及双侧大脑脚ADC值变化.结果 （1）正常人基底节区ADC值为（763.59±36.07）×10-3mm2/s,FA值为0.509±0.037,大脑脚ADC值为（803.81±47.01）×10-3mm2/s.（2）急性期所有患者梗死灶ADC值低于正常,随病情发展呈逐渐上升趋势,第4周左右等于正常（即为假正常）,慢性期高于正常值;所有患者梗死灶FA值随病情发展持续下降.（3）针灸组与非针灸组梗死灶ADC值、FA值差异有统计学意义（P＜0.05）,针灸组FA值大于非针灸组.结论 ADC及FA值变化情况能较早反映脑梗死患者病情变化并提示存在华勒变性.针灸治疗能缓解神经元坏死、华勒变性并促进神经功能重组.Objective To investigate the therapeutic effect of acupuncture in patients with stroke by diffusion tensor imaging （DTI）. Methods 30 healthy volunteers were chosen , 17 male, 13 female,range 19 to 62 years old ,mean age 55 years old. 20 patients with stroke were randomly divided into acupuncture group （10 cases） and non--acupuncture group（ 10 cases）. Western medicine treatment of the two groups were in line,acupuncture treatment was performed at hyperacute in acupuncture group. Experim nter are right handed, routine T2WI, FLAIR and DTI scan, continuous follow-up 8 weeks, one a week, FA values and ADC values in infarction lesions,and ADC values changes of bilateral cerebral peduncle were analyzed. Results （ 1 ）The ADC value and FA value in basal ganglia region of healthy volunteers were （763.59 ± 36.07）×10^-3 mm2/s, 0. 509. 11 ±0. 037 respectively, the ADC value of cerebral peduncle was [803.81±47.01）× 10-3mm2/s. （2）All patients were lower ADC values in acute phase,with the progression of the disease showed a rising trend,equal to normal about fourth week, ADC values were higher than normal in chronic phase. FA values in all patients with infarction lesions were decline. （3）There was a significant difference on ADC value and FA value between acupuncture group and non--acupuncture group （P〈0.05）, acupuncture group FA value is greater than non--acupuncture group. Conclusion The ADC and FA values could reflect earlier changes in patients with cerebral infarction and indicate the presence of Wallerian degeneration. Acupuncture therapy can alleviate neuronal necrosis, wallerian degeneration and promote the reorganization of neural function.

关 键 词：脑梗死 针灸 华勒变性 扩散张量成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]