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目的考察直立负荷试验诊断脑缺血疾病的价值。方法对２０例颈内动脉闭锁或狭窄及直立性低血压患者应用９９ｍＴｃ六甲基丙二胺肟（ＨＭＰＡＯ）进行直立负荷试验脑血流ＳＰＥＣＴ显像。２０例患者中，５例颈内动脉闭锁或狭窄＞７５％（Ａ组），８例直立位与平卧位收缩压差＞２６７ｋＰａ（Ｂ组）；对照组７例经超声心动图及ＣＴ或ＭＲＩ检查为正常非直立性低血压患者。受试者在２～３秒内由卧位转为直立位，即刻注入９９ｍＴｃＨＭＰＡＯ３７０ＭＢｑ后进行ＳＰＥＣＴ负荷显像，而后患者保持卧位不动，再次注入９９ｍＴｃＨＭＰＡＯ５５５ＭＢｑ，以同样采集条件再次行ＳＰＥＣＴ显像。比较两次显像结果，自选定的３个断面分别划取感兴趣区，作半定量分析，并与两小脑的平均值相比较。结果颈动脉闭锁或狭窄组ＳＰＥＣＴ直立显像所示放射性降低的区域，卧位显像可见放射性充填，病灶部位与小脑放射性比值明显上升（Ｐ＜００５）。８例直立性低血压患者中，６例直立显像示额叶放射性降低，卧位时额叶与小脑放射性比值上升，与直立位相比，差异有显著性（Ｐ＜００５）；对照组直立位与卧位显像均正常。直立位与卧位各部位与两小脑平均值之比差异无显著性。结论直立负荷试验有可能用于检测隐匿?
Objective To investigate the value of upright load test in diagnosis of cerebral ischemia. Methods Twenty patients with internal carotid artery atresia or stenosis and orthostatic hypotension were enrolled in this study. 99mTc-hexamethylpropane diamine oxime (HMPAO) was used to conduct an upright load test on cerebral blood flow SPECT imaging. Of the 20 patients, 5 had internal carotid artery atresia or stenosis> 75% (group A), and 8 patients had a difference in systolic pressure> 267 kPa between upright position and supine position (group B). In the control group, 7 patients underwent echocardiography and echocardiography CT or MRI examination for the normal non-orthostatic hypotension. Subjects in the 2 to 3 seconds from the supine to upright position, immediately injected 99mTc HMPAO370MBq after SPECT load imaging, and then keep the supine patient again injected 99mTc HMPAO555MBq again with the same collection conditions SPECT Imaging. The results of two imaging were compared. The three regions of interest were selected from the regions of interest for semi-quantitative analysis and compared with the average of two cerebellum. Results In the carotid atresia or stenosis group, the areas with decreased radioactivity showed by SPECT erect imaging. Radioactive filling was observed in the supine position, and the radioactivity ratio of the lesion to the cerebellum was significantly increased (P <005). In 8 patients with orthostatic hypotension, 6 patients showed eyelid radioactivity decreased in frontal radiography, and the ratio of frontal lobe to cerebellum increased in supine position, which was significantly different from that in orthostatic position (P <005) Vertical position and supine position were normal. There was no significant difference in the ratio of the vertical position and the supine position to the average of the two cerebellums. Conclusion Upright load test may be used to detect hidden?