核磁共振弥散加权成像联合波谱成像评价急性脑梗死药物疗效的价值研究  

Clinical research on acute cerebral infarction by diffusion-weighted MRI(DWI) plus magnetic resonance spectroscopy(MRS)

作　　者：韩立秀[1] 张振华[1] 张鹏[1] 张子宪[1] 胡屹伟[1] 

机构地区：[1]枣庄市立医院,山东枣庄277100

出　　处：《中医临床研究》2014年第19期136-138,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:核磁共振弥散加权成像(Diffusion-weighted MRI,DWI)及氢质子波谱成像(H Magnetic Resonance Spectroscopy,MRS)观察两组急性脑梗死患者治疗前后影像学改变和临床症状体征改善的情况,评价两组临床治疗方案治疗急性脑梗死的疗效。方法:选择发病24h内的急性脑梗死患者40例,随机分为研究组(20例)及对照组(20例)。对两组病人治疗前及治疗2周后用美国国立卫生研究院脑卒中量表评分(NIHSS评分)及应用磁共振弥散加权成像(DWI)及MRS在兴趣区上测量氮-乙酰天冬氨酸(NAA)与肌酸(Cr)比值(NAA/Cr);胆碱复合物(Cho)与肌酸(Cr)比值(Cho/Cr)及乳酸(Lac)与肌酸(Cr)比值(Lac/Cr),并对治疗前后结果进行统计学分析。结果:治疗2周后两组病人NIHSS评分较治疗前均有所降低,研究组较对照组下降明显(P<0.05),两组病人NAA/Cr较治疗前升高,但研究组较对照组升高明显(P<0.05)。两组病人CHO/Cr及Lac/Cr均较治疗前降低,但研究组较对照组降低明显(P<0.05),以上结果分析差异均有统计学意义。结论:应用MRS联合DWI能更好的指导临床治疗,脑蛋白水解物(施普善)是一种有效的治疗急性脑梗死的神经保护剂。To observe clinical effects on the different treatment of the acute cerebral infarction combined with diffusion-weighted MRI （DWI） and magnetic resonance spectroscopy （MRS）. Methods： 40 patients who had onset of acute cerebral infarction within 24 hours were randomly divided into treatment group （n=20） or the control group （n=20）. National institute of health stroke scale （NIHSS） and application in interest on MRS area measurement N-acetylaspartate （NAA） and creatine （Cr） ratio （NAA/Cr）;Choline complex （Cho） and creatine （Cr） ratio （Cho/Cr） and lactic acid （Lac） and creatine （Cr） ratio （Lac/Cr）were compared beteen two groups. Results： There were significant differences in NIHSS between treatment group and the control group after 2 weeks. The improvement in cerebrolysin treatment group was more significant than that of the control group （P〈0.05）. NAA/Cr were higher in cerebrolysin treatment group than that of the control group, the differences were significant （P〈0.05）. Two groups of patients CHO/Cr and Lac/Cr in cerebrolysin treatment group were lower than that of the control group, the differences were significant （P〈0.05）. Conclusion：Clinical application of MRS combining DWI can better guide the treatment, cerebrolysin is an effective neuroprotective agent in treating acute cerebral infarction .

关 键 词：急性脑梗死 磁共振氢质子波谱 磁共振弥散加权成像 Cerebrolysin(施普善) 

分 类 号：R743.33[医药卫生—神经病学与精神病学]