SPECT检查在猪脑缺血可逆时相窗诊断中的价值  

THE VALUE OF SPECT EXAMINATION IN THE DIAGNOSIS ON REVERSIBLE TIME WINDOW FOR CEREBRAL ISCHEMIA IN PIGS

作　　者：邢成名[1] 郑飞波[2] 卢辛明[1] 郑军[1] 王平[1] 王介之[1] 

机构地区：[1]青岛市市立医院神经内科,山东青岛266011 [2]青岛市市立医院核医学科,山东青岛266011

出　　处：《齐鲁医学杂志》2004年第1期39-40,42,共3页Medical Journal of Qilu

摘　　要：①目的　探讨超早期缺血性脑卒中可逆时相窗诊断的有效方法。②方法　将 12只猪随机分为阻断组和再灌注组 ,均用动脉夹夹断单侧颈总动脉。阻断组在第 2、4、5、6、8、10小时处死动物 ;再灌注组在相应时间去除颈总动脉夹形成再灌注脑缺血模型 ,2 4h后处死动物。所有动物在处死前均行SPECT显像检查、局部脑血流量测定 ,并行CT扫描 ;处死后行脑组织形态学观察。③结果　SPECT检查显示 :阻断颈总动脉即刻手术侧脑区出现明显放射性缺损 ,阻断 4h内去除动脉夹者放射性缺损区恢复正常 ;阻断 5h以上者 ,即使再灌注 ,放射性缺损区仍存在 ,并随着阻断时间的延长放射性缺损更加明显。CT显像则在阻断 8h后才出现异常。光镜、电镜观察显示 ,阻断 5h以上者阻断侧神经元略有肿胀 ,出现线粒体肿胀、线粒体嵴减少、胞质减少等病理性改变 ,少数出现核固缩并随阻断时间延长而逐渐加重 ;而阻断 4h以内去除动脉夹者 ,脑组织恢复正常。④结论　SPECT检查可超早期发现脑缺血 ,并提示脑缺血 5h就进入不可逆的状态。ObjectiveTo investigate the reversible time window in ultra-early stage of ischemic stroke(IS) and choose a valuable method for diagnosis of it. MethodsTwelve domestic pigs, in which, unilateral common carotid arteries were blocked by an artery clamp, were randomly divided into two groups: ischemic group and reperfusion group. The pigs in ischemic group were killed at the end of 2nd, 4th, 5th, 6th, 8th and 10th hour. The clamps of pigs in reperfusion group were removed at corresponding time and a reperfusion ischemic model was established. The experimental animals were killed 24 hours later. SPECT and X-CT examination were conducted on all pigs before they were killed and light microscopy and electron microscopy done to observe the morphology of the brain tissue.ResultsSignificant defect areas were observed by SPECT immediately after the arteries were blocked. No bilateral significant difference was observed within four hours after the clamps were removed, but the difference became evidently five hours later, and the difference increased with time extending. Abnormality appeared on CT scan only after eight hours of arterial blocking. Swelling neurons and mitochondria, less mitochondrial crests , swelling endothelium, decreased cytoplasm and a few pyknosis were observed microscopically and electron microscopically after more than five hours of arterial blocking, but recovery from swelling was found when artery clamps were removed before four hours.ConclusionSPECT may detect ultra-early cerebral ischemia and suggest that the ischemia is irreversible if it lasts for more than five hours. [

关 键 词：SPECT检查 脑缺血 可逆时相窗 诊断 

分 类 号：R743.3[医药卫生—神经病学与精神病学]