[目的]用磁敏感加权成像（susceptibility weighted imaging, SWI）测量针刺治疗脑梗死患者的静脉窦相位值，无创性评价静脉血氧饱和度改变，观察针刺穴位对脑组织血流灌注的影响。[方法]收集住院治疗的急性脑梗死患者60例为研究对象，随机分为针药合治组和药物治疗组各30例，分别采用常规药物及醒脑开窍针法联合药物治疗。于脑梗死后首诊（1～3d）及治疗后15d、30d分别行磁共振成像（magnetic resonance imaging, MRI）检查。SWI采用高分辨率三维扰相梯度回波序列，在获得的相位图上测量3个不同层面的上矢状窦和直窦相位值，采用重复测量方差分析进行统计学处理。[结果]急性脑梗死治疗前针药合治组与药物治疗组的直窦和上矢状窦相位值比较差异均无统计学意义（P>0.05）。针药合治组治疗前、治疗后15d、30d的直窦和上矢状窦相位值逐渐升高，药物治疗组也有升高。针药合治组治疗30d直窦相位值升高大于药物组，差异有统计学意义（P＜0.05）；针药合治组治疗15d和30d后上矢状窦相位值升高大于药物组，差异有统计学意义（P＜0.05，P＜0.001）。[结论]SWI静脉窦相位值测定有助于无创性评价脑组织血流灌注，针药合治可能更有效地改善脑梗死患者的脑组织血流灌注和脑血氧代谢情况。%Objective] To noninvasively evaluate venous blood oxygen saturation of the cerebral infarction patients who were treated by combining acupuncture with medicine using susceptibility weighted imaging(SWI) sequence to measure intracranial venous phase value. [Methods] Consecutive 60 cases of acute cerebral infraction who were admitted in our institution were recruited. Patients were subdivided randomized into two groups: being treated by combined Xingnao Kaiqiao needling method with medicine(group A, 30 cases) or by medicine only(group B, 30 cases). MRI scans were performed at initial diagnosis(1~3 days) and 15 days, then 30 days after treatment. High resolution three dimension spoiled gradient echo sequence was employed for susceptibility weighted imaging. Phase values of superior sagittal sinus and straight sinus were measured in 3 different slices. Repeated measurements analysis of variance was statistically studied.[Results] The phase value of straight sinus and superior sagittal sinus existed no significant differences(P>0.05) between acute cerebral infarction group A and group B. The phase values of straight sinus and superior sagittal sinus in group A increased continuously on SWI scanned prior to treatment. There were significant differences on the phase values of straight sinus 30 days after therapy(P<0.05), and superior sagittal sinus 15, 30 days after therapy(P<0.001)at different durations of treatment between group A and group B even though the phase values of both venous sinus in group B elevated after therapy. [Conclusions] It’s much helpful for assessment of cerebral perfusion by measuring phase value of venous sinus on SWI. Cerebral perfusion and blood oxygen saturation could be effectively improved when combined acupuncture with medicine treatment of the cerebral infarction.
展开▼
