论文部分内容阅读
目的探讨纹状体梗死后黑质继发性损害的发生发展过程及其潜在意义。方法连续收录初次发病、具有单侧基底节区局灶性梗死灶,纹状体明显受累的脑梗死患者11例。招募年龄性别相匹配健康志愿者11名作对照研究。患者分别在发病的第1周(W1)、第4周和第12周(W12)进行常规MRI和弥散张量(diffusion tensorimaging,DTI)检测,以及美国国立卫生研究院卒中评分(national institute health stroke scale,NIHSS)、Barthel生活指数(Barthel Index,BI)评定,在W12对部分有类似于帕金森氏病症状的患者采用帕金森氏病综合评分量表(unifiedParkinson s disease rating scale,UPDRS)的第Ⅲ分量表评价其严重程度。对照组于相同时间间隔进行DTI检测。结果与对照组比较,患者梗死灶同侧黑质的平均弥散量(mean diffusivity,MD)在各个时间点均明显升高:W1(对照组:0.709±0.005,患者组:0.732±0.121,P<0.01),W4(对照组:0.710±0.005,患者组:0.776±0.067,P<0.01),W12(对照组:0.713±0.005,患者组:0.904±0.112,P<0.01);而且随时间延长有逐步升高的趋势。有1例患者出现类似于帕金森氏病的症状,UPDRS的第Ⅲ分量表评分为18分。结论 DTI可以检测到纹状体梗死后黑质继发性损害的程度及其发展过程;黑质的继发性损害可能与患者出现类似于帕金森氏病的症状有关。
Objective To investigate the occurrence and development of secondary damage to substantia nigra after striatum infarction and its potential significance. Methods A total of 11 consecutive patients with cerebral infarction with unilateral basal ganglia focal infarction and striatum were included. The age and sex of recruits matched 11 healthy volunteers as a control study. Patients underwent routine MRI and diffusion tensorimaging (DTI) measurements at week 1 (W1), week 4, and week 12 (W12), respectively, and the National Institutes of Health Stroke Scores (national institute health stroke scale, NIHSS), and Barthel Index (BI), patients were treated with Parkinson’s disease rating scale (UPDRS) at section W12 for some patients with symptoms similar to Parkinson’s disease Ⅲ scale to assess the severity. The control group performed DTI test at the same time interval. Results Compared with the control group, mean diffusivity (MD) of ipsilateral substantia nigra was significantly increased at each time point: W1 (control group: 0.709 ± 0.005, patient group: 0.732 ± 0.121, P < 0.01), W4 (control group: 0.710 ± 0.005, patient group: 0.776 ± 0.067, P <0.01), W12 (control group: 0.713 ± 0.005, patient group: 0.904 ± 0.112, P <0.01) Gradually rising trend. One patient developed symptoms similar to Parkinson’s disease, and the UPRIS’s Scale III score was 18 points. Conclusions DTI can detect the degree of secondary damage to substantia nigra after striatum infarction and its development. The secondary damage to substantia nigra may be related to the appearance of symptoms similar to Parkinson’s disease.