脑梗死后活体脑代谢的磁共振定域波谱研究  

Proton magnetic resonance spectroscopy study on cerebral metabolism after infarction in rats

作　　者：胡卫星[1] 王建伟[1] 顾培元[1] 李丽云[2] 卢广[2] 胡红兵[2] 丁广良[2] 李立新[1] 吴幼章[1] 

机构地区：[1]南京医科大学第一附属医院神经外科,210029 [2]中科院武汉物理与数学研究所

出　　处：《江苏医药》2001年第11期816-819,共4页Jiangsu Medical Journal

摘　　要：目的　探讨脑梗死后脑梗死区及对侧大脑半球相应区域感兴趣区 (VOI)的代谢变化和高糖对各区域代谢的影响。方法　采用磁共振定域波谱技术 (MRS) ,在同一活体上分别连续测定梗死区与对照区的1H MRS。结果　梗死区胆碱 (Cho)、磷酸肌酸 /肌酸 (Pcr/Cr)、N 乙酰天门冬氨酸(NAA)强度均低于对照区 ,NAA在梗死急性期变化明显 ,加用高糖 30分钟后可见梗死区原有乳酸(Lac)信号成倍增加 (Lac/NAA 1 0 873) ,随着时间推移逐渐恢复 (Lac/NAA 0 30 13)。结论　 (1)采用MRS定域谱技术可更精确、更客观地检测各VOI区代谢变化。 (2 )脑梗死区NAA、Cho、Cr均有下降 ,而NAA下降更为明显 ,非梗死半球各指标无明显变化 ,NAA可望作为MRS早期诊断脑梗死的有效指标。 (3)高糖可加剧脑梗死区的病理代谢导致Lac积聚 ,及时停用高糖可望缓解Lac积聚状态。本文客观地直接展示了高糖加剧梗死区病理代谢的全过程 ,为改进临床治疗提供了直接有力的证据。Objective To study the energy metabolite changes in the infarction cores and contralateral areas,and the effect of administering high-glucose on the energy metabolism of both areas after infarction in rats.Methods Continually detecting and recording the energy metabolites of the VOIs in the same body in vivo by the VOI 1H MRS technique.Results The spectra exhibited a significant difference between infarction core and contralateral area in Cho/NAA,Pcr/Cr/NAA,Lac/NAA and Cho/Cr,NAA/Cr ratios.All values in ischemic cores declined continually after ischemia,and the values in contralateral areas were kept in normal.NAA dropped sharply in the early period of post-infarction.After administering high-glucose 30′,Lac signals increased greatly to -1.0873 Lac/NAA,and then decreased in the following time,finally returned to the original level -0.3013.Conclusion (1)The VOI 1H MRS technique can detect the energy metabolites in specific area more exactly and objectively,which can allow comparing the changes in different VOIs in the same body in vivo.(2)NAA greatly decreased in ischemic cores during the early period of infarction and went down earlier and sharper than the others.The change of NAA could be the important evidence for MRS to diagnose ischemia early.(3)Administering high-glucose depraved pathogenestic metabolism in ischemic core,and withdrawing it could reduce Lac accumulation.

关 键 词：脑梗死 脑代谢 磁共振波谱 MRS 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]