目的 观察急性脑梗死患者脑超慢涨落图的变化,研究急性脑梗死患者脑内神经递质的变化特点.方法 应用脑超慢涨落图技术检测53例急性脑梗死患者及30例正常健康者(对照组)脑内神经递质的变化,分析其与病程、病情、梗死范围及部位的关系.结果 急性脑梗死发病早期谷氨酸(Glu)、γ-氨基丁酸(GABA)、强兴奋物质(EXC)活动与恢复期及对照组比较,差异均有统计学意义(P＜0.05);恢复期各神经递质活动与对照组比较,差异均无统计学意义(P＞0.05).急性脑梗死患者发病早期,美国国立卫生研究院脑卒中量表(NIHSS)评分≥7分组Glu、EXC、强抑制物质(INH)活动与＜7分组比较,差异均有统计学意义(P＜0.05).梗死范围≥2cm×2 cm×2 cm组中Glu、乙酰胆碱(ACh)、EXC、去甲肾上腺素(NE)、多巴胺(DA)、INH活动与＜2 cm×2 cm×2cm组比较,差异均有统计学意义(P＜0.05).急性脑梗死患者发病早期幕上组中GABA、Glu、EXC活动与对照组比较,差异均有统计学意义(P＜0.05),幕上基底核组DA与对照组比较,差异有统计学意义(P＜0.05);幕下组GABA、Glu、5-羟色胺(5-HT)、EXC、NE活动与对照组比较,差异均有统计学意义(P＜0.05).结论 急性脑梗死患者脑内多种神经递质活动紊乱,其中Glu、GABA、EXC在脑梗死发病早期活动变化明显;Glu、EXC、INH的活动与病情密切相关;Glu、EXC、INH、ACh、NE、DA的活动受梗死范围的影响;单胺类神经递质(5-HT、NE、DA)的活动与特定梗死部位相关.%To investigate the changes of neurotransmitters in brain of patients with acute cerebral infarction by observing the changes of encephaloflnctnograph. Methods The changes of neurotransmitters were observed by Encephalofluc-tuography Technology in 53 patients with cerebral infarction and 30 healthy persons. The relationship between the changes and the disease courses, conditions, sizes and locations of infarction was analyzed. Results The activities of Glu, GAB A and EXC in the early stage of acute cerebral infarction showed statistically significant differences compared with those of the convalescence and the control group ( P < 0. 05 ) . The activities of neurotransmitters in convalescence showed no statistically significant differences compared with the control group ( P >0. 05 ) . In the early stage of acute cerebral infarction, the activities of Glu, EXC and INH in NIHSS≥7 group showed statistically significant differences compared with those of the NIHSS <7 group ( P<0. 05 ) . The activities of Glu, ACh, EXC, NE , DA and INH in infarction size ≥ 2 cm X 2 cm X 2 cm group showed statistically significant differences compared with those of the infarction size < 2 cm X 2 cm X 2 cm group ( P < 0. 05 ) . In the early stage of acute cerebral infarction, the activities of GAB A, Glu and EXC in supratentorial group showed statistically significant differences compared with those of the control group ( P < 0. 05 ) . The activity of DA in supratentorial basal ganglia group showed statistically significant difference compared with that of the control group ( P < 0. 05 ) . The activities of GAB A, Glu, 5 - HT, EXC and NE in subten-torial group showed statistically significant differences compared with those of control group ( P < 0. 05 ) . Conclusion Several neurotransmitters in patients with acute cerebral infarction have disorders, among which the activities changes of Glu, GABA and EXC are obvious in the early stage of the infarction. The activities of Glu, EXC and INH are closely related to the condition of the disease. The activities of Glu, EXC, INH, ACh, NE and DA are influenced by the size of cerebral infarction. The activities of 5- HT, NE and DA are related to the location of infarction.
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