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目的:探讨酰胺质子转移加权（APTw）成像在评估亚急性期脑梗死梗死核心（IC）及缺血半暗带（IP）的酸碱度（pH）变化价值。方法:前瞻性分析2019年4至11月大连医科大学附属第一医院23例单侧大脑中动脉供血区亚急性梗死患者（亚急性梗死组）的资料，另选15名健康志愿者作为对照组。所有受试者均接受常规MRI、DWI、动脉自选标记（3D-pCASL）及APTw检查。基于DWI图像、相对脑血流量（rCBF）及APTw图像确定亚急性梗死组IC及IP的范围，包括血流半暗带（CBF-DWI不匹配区，IPn CBF）以及代谢半暗带（APTw-DWI不匹配区，IPn APT），采用3D ROI半自动测量亚急性梗死组患者IC及IPn CBF的APTw值及体积。亚急性梗死组梗死侧与对侧APTw值比较、对照组双侧APTw值比较、IC与IPn CBF区APTw值比较采用配对样本n t检验或Wilcoxon符号秩检验，两组间比较采用独立样本n t检验或Mann-Whitney n U检验。IPn CBF1.5体积、IPn CBF2.5体积与IPn APT体积的比较采用Friedman检验。n 结果:亚急性梗死组IC区与梗死健侧、对照组间各APTw值间均差异无统计学意义（n P>0.05）。亚急性梗死组IPn CBF区与IC区APTw值差异有统计学意义（n P0.05). The APTw signals of IPn CBF and IC of the infarction group were statistically different (n P<0.05). Compared with the contralateral side of IPn CBF1.5 (3.7±1.7, -1.84±1.48, 5.57±2.75), the n APTwmax (3.07±1.41, n t=-3.012, n P=0.006), APTwn min [-1.30 (-1.74, -0.57), n Z=-2.099, n P=0.036], and n APTwmax-min(4.51±2.58, n t=-3.273, n P=0.003) signals in the IPn CBF1.5 were decreased (n P<0.05). Compared with the contralateral side of IPn CBF2.5 [-1.53 (-2.80, -0.91), 5.31±2.61], the APTwn min [-1.08 (-1.60, -0.49), n Z=-2.616, n P=0.009] and n APTwmax-min (4.41±2.72, n t=-3.228, n P=0.004) signals in the IPn CBF2.5 were decreased. The volumes of IPn CBF1.5 [107.51(50.08, 138.61)mmn 3], IPn APT [99.00 (53.27, 121.335) mmn 3] and IPn CBF2.5 [89.91 (51.53, 139.87) mmn 3] were successively reduced (χ2=7.913, n P=0.019), and the volume of IPn CBF2.5 was significantly smaller than that of IPn CBF1.5 (n P=0.037).n Conclusion:The acid-base metabolism in the IC of subacute cerebral infarction is not obvious, but the blood flow penumbra has local acid-base metabolism imbalance, and the range of metabolic penumbra coincides with the blood flow penumbra.