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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 investigate the clinical value of NIRS in detecting functional changes of brain during cognitive activation. Methods: Near-infrared spectroscopy (near infrared spectroscopy, NIRS) was used to monitor left anterior cerebral hemodynamics and cerebral hemodynamics in 36 subjects with cerebrovascular disease (CVD) aphasia, CVD non-aphasia and normal subjects The changes of parameters in non-fluent aphasia patients with CVD were compared with those in normal adult and non-aphasic patients with cerebrovascular disease. Results: ① The changes of NIRS parameters showed that both hemoglobin and total hemoglobin increased in 50% of non-aphasia patients and normal controls respectively, while the hemoglobin decreased significantly or slightly. ② In 50% of subjects with CVD aphasia, 16.7% of non-aphasia-non-aphasics subjects and normal subjects showed that reduced hemoglobin also increased with the increase of oxyhemoglobin and total hemoglobin. CONCLUSION: The activation of speech in the left prefrontal cortex of patients in each group showed a diversity of changes in cerebral oxygenation and hemodynamics. The reduction of hemoglobin in patients with aphasia also increased with the increase of oxyhemoglobin and total hemoglobin, suggesting that The aphasia patient’s left frontal cortex uses more oxygen during speech tasks than non-aphasic patients.