针刺激增即时SPECT脑显像识别脑血管病存活脑组织的研究  

Study on Survival Cerebral Tissue Detected by SPECT after Electroacupuncture in Cerebral Vascular Diseases

作　　者：郭松鹏[1] 路建平[1] 韩晓玲[1] 冯志徐[1] 张奇亮[1] 李书英[1] 

机构地区：[1]潍坊市人民医院,山东261041

出　　处：《中国针灸》2001年第11期673-676,共4页Chinese Acupuncture & Moxibustion

基　　金：山东省中医药管理局资助课题 (972 2 10 9)

摘　　要：目的 :观察电针刺激增即时单光子发射计算机断层 (SPECT)脑显像显示出的放射性填充病灶 (RFA)与临床神经功能的相关关系 ,为判定存活脑组织 (SCT)提供依据。方法 :测定双侧腧穴电针刺激增后99mTc ECD SPECT脑显像的RFA的容积激增率 (RIV)。然后进行以电针刺为主的综合性治疗 ,按治疗前后神经功能缺损积分变化 ,计算神经功能恢复率 (RNR)。结果 :37例患者的RNR >18% ,其RIV与RNR之间呈显著正相关关系 (r =0 6 31,P <0 0 1) ;有 35例 4 2处RFA与恢复的神经功能之间存在定量、定位关系 ,被判定为SCT阳性。该技术识别SCT的敏感性为94 5 9% ,特异性为 70 0 0 % ,阳性预测值为 83 33%。结论 :电针刺可即时激增RFA区域SCT的兴奋性 ,增加其对99mTc ECD的摄取。针刺后二次SPECT脑显像可定性、定位、定量显示CVD患者脑内散在的SCT。Purpose To observe the ralationship between the electroacupuncture-induced increase of volume of radioactivity-filled area (RFA) detected by SPECT and clinical neurofunctions in cerebrovascular disease (CVD) to determine the survival cerebral tissue (SCT).Methods Fourty-seven cas es of CVD were selected randomly.The rate of improvement of volume (RIV) of RFA after electroacupuncture at acupoints of both sides was determined with the double tomography of^99mTc-ECD-SPECT.All patients had been treated with comprehensive therapy for 20 days after SPECT.The rate of neurofunction recovery(RNR) was measuued on the base of neurofunction deficit scores.Results There was positive correlation between RIV and RNR in thirty-seven patients whose RNR was more than 18%(r=0631,P<001).According to the location stansard of cerebral neurofunction,the relationship between position and neurofunction(had recovered) of fourty-two patients(35 RFAs) was determined.These RFAs were confirmed as p ositive SCT and located around radioactive lack areas(RLA),or mix with RLA,or away from RLA.Two patients(3RFAs) were regarded as false negative SCT,five(6 RFAs) as false positive and five as negative.Conclusion Electroacupuncture can immediately enhance the cerebral excitablity and increase the ability of cerebrum tissue uptaking^99mTc-ECD.The second SPECT after electroacupuncture can show the location,quantity and nature of SCT in the brain of the patient of CVD.

关 键 词：存活脑组织 脑血管病 针灸疗法 体层摄影术 发射型计算机 

分 类 号：R277.73[医药卫生—中医学] R246.6