肝豆状核变性患者局部脑血流量及其相关因素的研究  

Study on regional cerebral blood flow and correlated factors in patients with hepatolenticular degeneration

作　　者：苏增锋 张颖 胡文彬[2] 韩咏竹[2] 杨任民[2] 

机构地区：[1]合肥市滨湖医院 安徽医科大学第三附属医院干部病房,230061 [2]安徽中医学院神经病学研究所附属医院神经内科,合肥230061

出　　处：《中国医师进修杂志》2015年第2期79-82,共4页Chinese Journal of Postgraduates of Medicine

基　　金：基金项目：国家自然科学基金（81072738）;安徽省自然科学基金（050430803）

摘　　要：目的 研究肝豆状核变性（HLD）患者局部脑血流量（rCBF）及其相关因素.方法 采用磁共振灌注技术检测14例脑型（脑型组）和10例非脑型（非脑型组）HLD患者豆状核、丘脑等部位的rCBF,为避免灌注时间差的影响,计算相对局部脑血流量（rrCBF）,并与13例健康志愿者（对照组）进行比较.评价HLD患者临床症状评分、尿排铜量、病程与rrCBF的相关性.结果 脑型组左右侧额叶、颞叶、豆状核、尾状核头、丘脑、中脑、脑桥和左侧海马、小脑皮质、齿状核部位rrCBF与对照组比较减低（1.91±0.35比2.44±0.64,1.80±0.30比2.37±0.65,1.37±0.35比2.14 ±0.91,1.58 ± 0.52比2.39±0.99,1.61±0.38比2.59±0.74,1.52±0.64比2.63±0.73,1.88±0.32比2.61±0.67,1.70±0.40比2.35±0.50,1.48±0.13比2.01±0.59,1.46±0.38比2.38±0.99,1.47±0.55比2.02±0.72,1.27±0.48比1.91 ±0.51,1.24±0.38比1.47±0.29,1.25±0.39比1.53±0.37,1.74±0.27比2.40±0.89,1.79±0.50比2.22±0.66,2.15±0.41比2.64±0.61）,差异有统计学意义（P＜ 0.05或＜0.01）;脑型组顶叶、枕叶等部位rrCBF与对照组比较差异无统计学意义（P＞0.05）;脑型组左右侧豆状核部位rrCBF与非脑型组比较减低（1.61 ± 0.38比1.94±0.58,1.52±0.64比1.99±0.59）,差异有统计学意义（P＜0.05）.24例HLD患者临床症状评分与左右侧豆状核部位rrCBF呈明显负相关（r值分别为-0.792和-0.764,P＜0.01）,而尿排铜量及病程与左右侧豆状核部位rrCBF无相关性（P＞0.05）.结论 脑型和非脑型HLD患者rCBF均有明显减低,而脑型较非脑型HLD患者rCBF减低更广泛、更严重.rCBF与临床症状评分相关.Objective To study the regional cerebral blood flow （rCBF） and correlated factors in patients with hepatolenticular degeneration （HLD）.Methods The rCBF of lentiform nucleus,thalamus and other sites in 14 patients with HLD of cerebral type （cerebral type group） and 10 patients with HLD of non-cerebral type （non-cerebral type group） were determined by magnetic resonance-perfusion imaging technology,meanwhile 13 healthy volunteers were selected as control group,and calculated the relative regional cerebral blood flow （rrCBF） for avoiding perfusion time lag.The correlation between the clinical symptom scores,the content of urinary copper,duration and rrCBF in HLD patients were evaluated.Results The rrCBF of cerebral type group in the left and right frontal lobe,temporal lobe,lentiform nucleus,caudate nucleus,thalamus,midbrain,pons and the left hippocampus,cerebellar cortex,dentate nucleus were lower than those of control group （1.91 ±0.35 vs.2.44 ±0.64,1.80 ±0.30 vs.2.37 ±0.65,1.37 ±0.35 vs.2.14 ±0.91,1.58 ±0.52 vs.2.39 ±0.99,1.61 ±0.38 vs.2.59 ±0.74,1.52 ±0.64 vs.2.63 ±0.73,1.88 ±0.32 vs.2.61 ±0.67,1.70 ±0.40 vs.2.35 ±0.50,1.48 ±0.13 vs.2.01 ±0.59,1.46 ±0.38 vs.2.38 ±0.99,1.47 ±0.55 vs.2.02 ±0.72,1.27 ±0.48 vs.1.91 ±0.51,1.24 ±0.38 vs.1.47 ±0.29,1.25 ±0.39 vs.1.53 ±0.37,1.74 ±0.27 vs.2.40 ±0.89,1.79 ±0.50 vs.2.22 ±0.66,2.15 ±0.41 vs.2.64 ± 0.61）,and there were significant differences （P 〈 0.05 or 〈 0.01）.There were no significant differences in the rrCBF of the parietal and occipital lobe,etc between cerebral type group and control group （P 〉 0.05）.The rrCBF of cerebral type group in the left and right lentiform nucleus were lower than those of non-cerebral type group （1.61 ± 0.38 vs.1.94 ± 0.58,1.52 ± 0.64 vs.1.99 ± 0.59）,and there were significant differences （P 〈 0.05）.The clinical symptom scores were positively correlated with the rrCBF of the left and right lentiform nucleus in 24 patients with HLD （r =-0.792 and-0.764,P 〈

关 键 词：肝豆状核变性 灌注成像 局部脑血流量 临床症状 

分 类 号：R742.4[医药卫生—神经病学与精神病学]