中风后非流畅型失语症患者语言激活时左前额皮层血氧反应及血流动力学变化:NIRS的研究  

Language-activated cerebral blood oxygenation and hemodynamic changes of the left prefrontal cortex in poststroke aphasic patients:A near infrared spectroscopy study

作　　者：谢欲晓[1] 沈抒[1] 孙启良[1] 大西幸子[1] 敖纯利[1] 李荔[2] 酒谷薰宗 左焕宗[3] 

机构地区：[1]中日友好医院康复医学科,北京和平街北口100029 [2]中日友好医院ICU [3]中日友好医院神经外科

出　　处：《中国康复医学杂志》2004年第1期6-10,共5页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:探讨NIRS检测认知激活状态大脑功能性变化的临床应用价值。方法:运用近红外光谱(nearinfraredspectroscopy,NIRS)技术监测脑血管病(CVD)失语症组、CVD非失语症组及正常人组共36名被试语言活动时大脑左前额氧代谢和血流动力学的相应变化,并将CVD合并非流畅性失语症患者的参数变化与正常的成年人及脑血管病未合并失语症患者的变化进行了比较。结果:①NIRS参数的变化在CVD非失语症组及正常人组中均各有50%被试呈现氧合血红蛋白和总血红蛋白同时上升,而还原血红蛋白无明显改变或稍有下降。②CVD失语症组中50%的被试、CVD非失语症组与正常人组各有16.7%被试显示随着氧合血红蛋白和总血红蛋白的增加,还原血红蛋白亦有所增加。结论:语言激活在各组被试的左前额皮层的脑血氧反应和血流动力学变化呈现多样性,失语症患者的还原血红蛋白随着氧合血红蛋白和总血红蛋白的增加亦有所增加,提示失语病人的左前额皮层在语言任务期间比非失语病人利用更多的氧。Objective:To explore the clinical value for brain functional changes of cognitive activation status with near infrared spectroscopy.Method:We investigated the different changes of cerebral blood oxygenation and hemodynamics in the left prefrontal cortex induced by language activities among normal, poststroke non-aphasia and nonfluent aphasia using NIRS, and compared the parameters changes of aphasia with non-aphasia and normal. Result:①In 50% of CVD non-aphasia patients and 50% of normal, Oxy-Hb and Total-Hb increased, meanwhile, Deoxy-Hb did not change or decreased slightly.②In 50% of CVD aphasia,16% of CVD non-aphasia and normal respectively, Oxy-Hb and Total-Hb increased, meanwhile Deoxy-Hb also increased. Conclusion: A multiplicity of changes of cerebral blood oxygenation and hemodynamics in the left prefrontal cortex induced by language activities.The increase of Deoxy-Hb with increases of Oxy-Hb and Total-Hb in aphasia patients suggests that the left prefrontal cortex of aphasics utilized more oxygen than non-aphasia during language tasks.Author′s address Dept.of Physical Medicine and Rehabilitation,China-Japan Friendship Hospital, Beijing, 100029

关 键 词：中风 非流畅型失语症 语言激活 左前额皮层 血氧反应 血流动力学 近红外光谱 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R767.64[医药卫生—临床医学]