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应用Xe-CT技术研究老年人脑白质损害(WML)的脑血管反应性(CVR) 被引量：2

Cerebrovascular reactivity(CVR) to acetazolamide in the elderly with different extent of white matter lesions(WML):an xenon-computed tomography study
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摘要 目的观察老年人不同级别脑白质损害(white matter lesions,WML)的脑血管反应性(cerebrovascularreactivity,CVR)。方法根据头颅磁共振FLAIR序列显示的WML程度,应用Fazekas改良量表,将WML分为2个部位:皮层下深部白质区(subcortical deep white matter hyperintensity,SDWMH)及侧脑室周边区(periventricular hyperintensity,PVH);3个等级:0～1级;2级及3级。对所有研究对象给予1g乙酰唑胺静脉推注,应用氙气增强CT技术测定不同级别WML病损区域内负荷前后的局部脑血流(regional cerebral bloodflow,rCBF),观察其CVR。结果 33例对象纳入本研究,平均年龄(74.4±7.2)岁。不同级别SDWMH中,0～1级者负荷前rCBF(单位:mL.100g-1.min-1)为18.11,负荷后为32.99(P=0.000);2级者负荷前rCBF为14.60,负荷后为21.63(P=0.004);3级者负荷前rCBF为10.56,负荷后为10.63(P=0.448)。不同级别PVH中,0～1级者负荷前rCBF为23.55,负荷后为35.49(P=0.000);2级者负荷前rCBF为15.39,负荷后为16.03(P=0.032);3级者负荷前rCBF为10.35,负荷后为9.88(P=0.533)。结论无论是SDWMH,还是PVH,病损越严重,静息状态下rCBF越低;且乙酰唑胺负荷后rCBF增幅也越小,CVR越差。本研究结果提示,脑血流自动调节受损可能是老年WML的重要发病机制。 Objective To observe the relationship between the severity of white matter lesions （WML） and cerebrovascular reactivity（CVR）in normal elderly. Methods All participators were divided into 2 catigeries：subcortical deep white matter hyperintensity and periventricular hyperintensity （SDWMH） and periventricular hyperintensity （PVH）, and 3 grades： grade 0 - 1, grade 2 and grade 3, according to the severity of WML showing on the FLAIR sequence of MRI using modified Fazekas scale. The values of regional cerebral blood flow within lesions in all participators were measured using xenon contrast CT before and 20 minutes later after 1 g acetazolamide injection. Results A total of33 elderly peoples were enrolled in this study with the average age of （74.4 ＋ 7.2） years. In SDWMH group, regional cerebral blood flow （rCBF,mL · 100 g-1· min-1） was 18.11 vs 32.99 （P = 0. 000） in grade 0- 1;14.6 vs 21.63 （P =0.004） in grade 2;and 10.56 vs 10. 63 （P =0.448） before and after acetazotamide injection respectively. In PVH group, rCBF was 23.55 vs 35.49 （P = 0. 000） in grade 0 - 1 ~15.39 vs 16. 03（P= 0. 032） in grade 2; and 10. 35 vs 9. 88 （P = 0. 533）before and after acetazolamide injection, respectively. Conclusions The severity of WML both in SDWMH and in PVH is significantly associated with reduction of rCBF within lesions before and after acetazolamide injection and the poor CVR. This study shows that cerebral hemodynamics may play a key role on the pathogenesis of WML in the elderly.
作者 付建辉 董强 姚振威 周华琳 洪震
机构地区 复旦大学附属华山医院神经内科 复旦大学附属华山医院放射科
出处 《复旦学报（医学版）》 CAS CSCD 北大核心 2012年第2期157-161,共5页 Fudan University Journal of Medical Sciences
基金 上海市卫生局科研项目(2009007)~~
关键词 脑白质损害(WML) 脑血管反应性(CVR) 局部脑血流(rCBF) white matter lesions （WML） cerebrovascular reactivity （CVR） regional cerebralblood flow （rCBF）
分类号 R816.1 [医药卫生—放射医学] R742 [医药卫生—神经病学与精神病学]
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参考文献21

  • 1Debette S,Markus HS.The clinical importance of whitematter hyperintensities on brain magnetic resonanceimaging:systematic review and meta-analysis[J].BMJ,2010,341:3666.
  • 2O’Sullivan M.Leukoaraiosis[J].Pract Neurol,2008,8(1):26-38.
  • 3Fu JH,Lu CZ,Hong Z,et al.Extent of white matterlesions is related to acute subcortical infarcts and predictsfurther stroke risk in patients with first ever ischaemicstroke[J].J Neurol Neurosurg Psychiatry,2005,76(6):793-796.
  • 4Pantoni L,Poggesi A,Inzitari D.The relation betweenwhite-matter lesions and cognition[J].Curr Opin Neurol,2007,20(4):390-397.
  • 5Jokinen H,Gouw AA,Madureira S,et al.LADIS studygroup.Incident lacunes influence cognitive decline:theLADIS study[J].Neurology,2011,76(22):1872-1878.
  • 6Srikanth V,Beare R,Blizzard L,et al.Cerebral whitematter lesions,gait,and the risk of incident falls:aprospective population-based study[J].Stroke,2009,40(1):175-180.
  • 7付建辉,袁晶,李胜,郭起浩,洪震,董强,吕传真,赵倩华.老年人不同程度脑白质损害脑血流定量研究[J].中华医学杂志,2009,89(17):1175-1178. 被引量：8
  • 8Pantoni L.Cerebral small vessel disease:from pathogenesis andclinical characteristics to therapeutic challenges[J].TheLancet Neurol,2010,9(7):689-701.
  • 9Kapeller P,Barber R,Vermeulen R J,et al.European taskforce of age related white matter changes.visual rating ofage-related white matter changes on magnetic resonanceimaging:scale comparison,interrater agreement,andcorrelations with quantitative measurements[J].Stroke,2003,34(2):441-445.
  • 10Matsu E,Sugihara S,Fujii S,et al.White matter changesin elderly people:MR-pathologic correlations[J].MagnReson Med Sci,2006,5(2):99-104.

二级参考文献18

  • 1O'Sullivan M. Leukoaraiosis. Pract Neurol, 2008,8:26-38.
  • 2Fu JH, Lu CZ, Hong Z, et al. Extent of white matter lesions is related to acute subcortical infarcts and predicts further stroke risk in patients with first ever ischaemic stroke. J Neurol Neurosurg Psychiatry, 2005,76:793-796.
  • 3Pantoni L, Poggesi A, Inzitari D. The relation between whitematter lesions and cognition, 2007,20:390-397.
  • 4Baezner H, Blahak C, Poggesi A, et al. Association of gait and balance disorders with age-related white matter changes : the LADIS Study. Neurology, 2008,70 : 935-942.
  • 5Fazekas F, Kleinert R, Offenbacher H, et al. Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology, 1993, 43 : 1683-1689.
  • 6Fu JH, Lu CZ, Hong Z, et al. Relationship between cerebral vasomotor reactivity and white matter lesions in elderly subjects without large artery occlusive disease. J Neuroimaging, 2006, 16: 120-125.
  • 7Miyazawa N, Satoh T, Hashizume K, et al. Xenon contrast CTCBF measurements in high-intensity loci on T2-weighted MR images in centrum semiovale of asymptomatic individuals. Stroke, 1997, 28: 984-987.
  • 8Hatazawa J, Shimosegawa E, Satoh T, et al. Subcortical hypoperfusion associated with asymptomatic white matter lesions on magnetic resonance imaging. Stroke, 1997, 28 : 1944-1947.
  • 9O'Sullivan M, Lythgoe DJ, Pereira AC, et al. Patterns of cerebral blood flow reduction in patients with ischemic leukoaraiosis. Neurology, 2002, 59:321-326.
  • 10Wahlund LO, Barkhof F, Fazekas F, et al. A new rating scale for age-related white matter changes applicable to MRI and CT. Stroke, 2001, 32 : 1318-1322.

共引文献7

同被引文献59

  • 1Greeter BE, Schulz UG. AN-related cerebral white matter disease (leukoaraiosis): a review. Postcad Med J, 2012, 88: 79-87.
  • 2Topakian R, Barrick TR, Howe FA, et al. Blood-brain barrier permeability is increased in normal-appearing white rmtter in patients with lacunar stroke and leucoaraiosis. J Neurol Neurosurg Psychiatry, 2010, 81: 192-197.
  • 3Guo L, Zhu N, Guo Z, et al. Particulate matter (PM10) exposure induces endothelial dysfunction and inflammation in rat brain. J Hazard Mater, 2012, 213-214: 28-37.
  • 4Rosenberg GA. Inflarranation and white matter damage in vascular cognitive impairment. Stroke, 2009, 400 Suppl): S20-S23.
  • 5Umemttra T, Kawamura T, Umegaki H, et al. Endothelial and inflarmory n-ekers in relation to progression of ischaenfic cerebral small-vessel disease and cognitive impainrent: a 6-year longitudinal study in patients with type 2 diabetes mellitus. J Neurol Neurosurg Psychiatry, 2011, 82: 1186-1194.
  • 6Chrissobolis S, Banff B, Sobey CG, et al. Role of Nox isoforms in angiotensin ]I-induced oxidative stress and endothelial dysfunction in brain. J Appl Physiol, 2012, 113: 184-191.
  • 7Simone M J, Tan ZS. The role of inflammation in the pathoesis of delirium and dementia in older adults: a review. CNS Neurosci Ther, 2011, 17: 506-513.
  • 8Knottnerus IL, Ten Cate H, Lodder J, et al. Endothelial dysfunction in lacunar stroke: a systematic review. Cerebrovasc Dis, 2009, 27: 519-526.
  • 9Giwa MO, Williams J, Elderfield K, et al. Neuropathologic evidence of endothelial changes in cerebral small vessel disease. Neurology, 2012, 78: 167-174.
  • 10Lockman JA, Geldenhuys WJ, Jones-Hisgms MR, et al. NGP1-01, a multi-targeted polycyclie cage amine, attenuates brain endothelial cell death in iron overload conditions. Brain Res, 2012, 1489: 133- 139.

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复旦学报（医学版）
2012年 第2期

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