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目的 探讨狼疮脑和非狼疮脑患者脑血供的差别。方法 用单光子发射电子计算机扫描 (SPECT)观察脑血流的变化 ,选择脑感兴趣区及半定量计算非对称指数 (AI)法分析 ,狼疮脑患者同时行核磁共振 (MRI)检查。结果 2 0例狼疮脑 (Ⅰ组 )和 2 3例非狼疮脑 (Ⅱ组 )SPECT血流减少部位分别为 83处和 74处 (P >0 0 5 ) ;AI值Ⅰ、Ⅱ组分别为 6 85± 1 98和 6 45± 1 87(P >0 0 5 )。两组患者血流灌注不足的部位依次主要分布在额叶、顶叶和颞叶 ,其次是枕叶和小脑。Ⅰ组中 14例MRI检查发现 87处病灶 ,同时有SPECT和MRI异常部位 5 1处 (占 81% ) ,其中 12例患者的神经精神症状至少和一处SPECT异常有关。结论 SPECT是早期判断系统性红斑狼疮脑损害的敏感检查方法
Objective To investigate the differences of cerebral blood supply between patients with lupus and non-lupus. Methods The changes of cerebral blood flow were observed by single photon emission computed tomography (SPECT). The area of interest in the brain and the semi-quantitative calculation of the asymmetry index (AI) were used to analyze the MRI findings. Results 20 cases of lupus brain (group Ⅰ) and 23 cases of non-lupus brain (group Ⅱ) SPECT blood flow reduction sites were 83 and 74 (P 0 05); AI values Ⅰ and Ⅱ were 6 85 ± 1 98 and 6 45 ± 1 87 (P> 0.05). Two groups of patients with hypoperfusion sites followed by the main distribution in the frontal lobe, parietal lobe and temporal lobe, followed by the occipital lobe and cerebellum. In group Ⅰ, 87 lesions were detected by MRI in 14 cases, with 51 lesions (81%) in SPECT and MRI abnormalities. Neuropsychiatric symptoms in at least 12 patients were related to one SPECT abnormality. Conclusion SPECT is a sensitive method for early detection of brain damage in systemic lupus erythematosus