【摘要】 目的探讨正电子发射型断层扫描（PET）脑代谢-脑血流联合显像应用于肢体远隔缺血预适应(LRIC治疗缺血性脑血管病（ICVD）疗效的评估价值。方法回顾性分析2012年1月至2015年1月首都医科大学宣武医院神经外科收治的25例ICVD患者的¹⁸F-FDG脑代谢和¹³N-Ammonia脑血流PET显像结果,比较治疗前后PET影像以及脑代谢值、脑血流值、脑代谢减低率和脑血流减低率的变化。结果对于脑血流和/或脑代谢轻度受损的ICVD患者来说,LRIC的治疗基本有效,部分病灶脑代谢值或脑血流值恢复正常,治疗前后脑代谢值和脑血流值对比,差异有统计学意义（P <0. 05）,特别是部分单纯轻度脑血流受损的ICVD患者,经过LRIC治疗后,病灶脑血流值均与健侧对比,差异无统计学意义（P>0. 05）;对于脑血流和/或脑代谢中度和部分重度受损的患者来说,多数病灶脑代谢和脑血流有所改善;对于部分脑血流和/或脑代谢严重受损的患者来说,LRIC治疗效果不明显。结论 PET脑代谢-脑血流联合显像是评价LRIC治疗ICVD疗效的良好方法,并具有较好的应用前景。更多还原

【Abstract】 Objective To evaluate the value of Positron Emission Tomography （PET） brain metabolism-cerebral blood flow imaging in the efficacy evaluation of limb remote ischemic conditioning （LRIC） in the treatment of ischemic cerebrovascular disease （ICVD）. Methods 25 patients with ICVD admitted in the Department of Neurosurgery of Xuanwu Hospital from January 2012 to January 2015 were enrolled in this retrospective study. The patients’ ¹⁸F-FDG PET brain metabolic and ¹³N-Ammonia cerebral blood flow imaging results were analyzed,and the PET imaging before and after treatment,cerebral metabolic rate,cerebral metabolic rate,as well as the reduced value of cerebral metabolic rate and cerebral blood flow were compared. Results For ICVD patients with mildly impaired cerebral blood flow and/or cerebral metabolism,the treatment of LRIC is basically effective,and the cerebral metabolic value or cerebral blood flow value of some lesions returned to normal,and there was significant difference in cerebral metabolic value and cerebral blood flow value between before and after treatment （P < 0. 05）. Especially for some ICVD patients with only mildly impaired cerebral blood flow,after LRIC treatment,there was no significant difference between the cerebral blood flow value of the lesion and of the healthy side （P > 0. 05）. For patients with moderately and partially severely impaired cerebral blood flow and/or cerebral metabolism,cerebral metabolism and cerebral blood flow improved in most lesions. For some patients with severely impaired cerebral blood flow and/or cerebral metabolism,LRIC treatment effect may not be obvious. Conclusion PET brain metabolism-cerebral blood flow imaging is a good method to evaluate the efficacy of LRIC in the treatment of ICVD and has a good application prospect.更多还原