目的旨在应用4D血流MR成像研究正常志愿者及大脑中动脉(MCA)狭窄病人的颅内动脉血流动力学状态,并比较正常和狭窄颅内动脉的双侧血流动力学参数差异。方法纳入正常志愿者5名和MCA狭窄病人3例。应用3 T MR设备进行检查,采用3D时间飞跃法(...目的旨在应用4D血流MR成像研究正常志愿者及大脑中动脉(MCA)狭窄病人的颅内动脉血流动力学状态,并比较正常和狭窄颅内动脉的双侧血流动力学参数差异。方法纳入正常志愿者5名和MCA狭窄病人3例。应用3 T MR设备进行检查,采用3D时间飞跃法(TOF)MRA及高分辨3D-T1WI-SPACE序列显示及分析Willis环结构特点。应用4D血流MR成像获取血流数据,分析双侧颈内动脉(ICA)颅内段、MCA及大脑前动脉(ACA)的血流动力学状态,计算心动周期不同时相的平均血管面积、平均及最大血流速度、平均瞬时血流率,生成血流矢量图、流线图及粒子追踪图。分析颅内Willis环的结构特征及血流动力学状态。采用独立样本t检验比较正常志愿者及MCA狭窄病人双侧动脉血流动力学参数的差异。结果正常志愿者中,4名显示对称Willis环结构,1名右侧胚胎型大脑后动脉。双侧ICA、MCA和ACA的血流动力学参数包括平均血管面积、平均血流速度、最大血流速度和平均瞬时血流率之间差异均无统计学意义(均P>0.05)。血流矢量图、流线图及粒子追踪图显示,ICA可见高速血流,收缩晚期及舒张期显示血流速度下降,血流分布欠均匀。1名右侧胚胎型大脑后动脉志愿者双侧血流动力学参数明显不对称,除右侧ACA最大血流速度低于左侧,其余颅内血管段的平均血管面积、平均和最大血流速度以及平均瞬时血流率右侧均明显高于左侧。3例MCA狭窄病人的ICA、MCA及ACA双侧血流动力学参数之间的差异未见统计学意义(P>0.05)。3例狭窄侧平均瞬时血流率均低于对侧。2例局部平均血流速度及相对压力梯度较对侧降低;另1例则明显较对侧增大。血流矢量图、流线图及粒子追踪图显示狭窄局部血流矢量明显偏离血管主轴方向,血流分布明显不规则。结论应用4D血流MR成像可以提供对颅内动脉复杂血流动力学状态的综合评估,包括对血流�展开更多
Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the...Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the relationship between serum bilirubin levels and different degrees of atherosclerotic stenosis in intracranial or extracranial arteries. Methods: The study included 189 patients undergoing digital subtraction angiography (DSA) diagnosed as being normal or having been confirmed as atherosc lerotic stenosis in the intracranial or extracranial arteries. The patients were allocated to normal, mild (Results: Indirect bilirubin (Ibil) concentrations increased in parallel with the increasing severity of atherosclerotic stenosis in the intracranial or extracranial arteries, but decreased in patients with occluded cranial vessels. Multivariate analysis showed that Ibil levels were significantly higher in patients with severe stenosis group than in those with mild stenosis (OR, 1.464;95% CI, 1.050 - 2.042;P = 0.024). However, Ibil levels were significantly lower in patients with occlusion than in those with severe stenosis (OR, 0.790;95% CI, 0.684 - 0.913;P = 0.001). Conclusions: Ibil appears to have a protective effect against the development of atherosclerotic stenosis in intracranial or extracranial arteries. The biosynthesis of Ibil increases with stenosis progresses but decreases once occlusion occurs.展开更多
目的：探讨长期服用氯氮平的慢性精神分裂症患者颈部、颅内动脉粥样硬化病变状况。方法将研究对象分为3组：50例健康人群为对照组，50例慢性精神分裂症服用氯丙嗪（5～10年）患者为氯丙嗪组，50例慢性精神分裂症服用氯氮平（5～10年）...目的：探讨长期服用氯氮平的慢性精神分裂症患者颈部、颅内动脉粥样硬化病变状况。方法将研究对象分为3组：50例健康人群为对照组，50例慢性精神分裂症服用氯丙嗪（5～10年）患者为氯丙嗪组，50例慢性精神分裂症服用氯氮平（5～10年）患者为氯氮平组。颈动脉超声和经颅多普勒超声检测颈动脉、颅内动脉粥样硬化状况；测定空腹血糖（FPS）、血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、氧化修饰低密度脂蛋白（ox-LDL）。结果氯氮平组患者颈动脉内-中膜增厚、斑块形成及狭窄发生率均明显高于对照组和氯丙嗪组（P ＜0．05或 P ＜0．01）；颅内动脉狭窄发生率明显高于对照组（P ＜0．05）。氯氮平组与氯丙嗪组血 FPS、TG、TC、LDL、ox-LDL 水平明显高于对照组（P ＜0．05或 P ＜0．01），氯氮平组明显高于氯丙嗪组（P ＜0．05或 P ＜0．01）。结论长期服用氯氮平的慢性精神分裂症患者颈部、颅内动脉可发生不同程度的粥样硬化病变，可能与其引起的血脂异常、血糖升高及抗氧化能力降低有关。展开更多
文摘目的旨在应用4D血流MR成像研究正常志愿者及大脑中动脉(MCA)狭窄病人的颅内动脉血流动力学状态,并比较正常和狭窄颅内动脉的双侧血流动力学参数差异。方法纳入正常志愿者5名和MCA狭窄病人3例。应用3 T MR设备进行检查,采用3D时间飞跃法(TOF)MRA及高分辨3D-T1WI-SPACE序列显示及分析Willis环结构特点。应用4D血流MR成像获取血流数据,分析双侧颈内动脉(ICA)颅内段、MCA及大脑前动脉(ACA)的血流动力学状态,计算心动周期不同时相的平均血管面积、平均及最大血流速度、平均瞬时血流率,生成血流矢量图、流线图及粒子追踪图。分析颅内Willis环的结构特征及血流动力学状态。采用独立样本t检验比较正常志愿者及MCA狭窄病人双侧动脉血流动力学参数的差异。结果正常志愿者中,4名显示对称Willis环结构,1名右侧胚胎型大脑后动脉。双侧ICA、MCA和ACA的血流动力学参数包括平均血管面积、平均血流速度、最大血流速度和平均瞬时血流率之间差异均无统计学意义(均P>0.05)。血流矢量图、流线图及粒子追踪图显示,ICA可见高速血流,收缩晚期及舒张期显示血流速度下降,血流分布欠均匀。1名右侧胚胎型大脑后动脉志愿者双侧血流动力学参数明显不对称,除右侧ACA最大血流速度低于左侧,其余颅内血管段的平均血管面积、平均和最大血流速度以及平均瞬时血流率右侧均明显高于左侧。3例MCA狭窄病人的ICA、MCA及ACA双侧血流动力学参数之间的差异未见统计学意义(P>0.05)。3例狭窄侧平均瞬时血流率均低于对侧。2例局部平均血流速度及相对压力梯度较对侧降低;另1例则明显较对侧增大。血流矢量图、流线图及粒子追踪图显示狭窄局部血流矢量明显偏离血管主轴方向,血流分布明显不规则。结论应用4D血流MR成像可以提供对颅内动脉复杂血流动力学状态的综合评估,包括对血流�
文摘Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the relationship between serum bilirubin levels and different degrees of atherosclerotic stenosis in intracranial or extracranial arteries. Methods: The study included 189 patients undergoing digital subtraction angiography (DSA) diagnosed as being normal or having been confirmed as atherosc lerotic stenosis in the intracranial or extracranial arteries. The patients were allocated to normal, mild (Results: Indirect bilirubin (Ibil) concentrations increased in parallel with the increasing severity of atherosclerotic stenosis in the intracranial or extracranial arteries, but decreased in patients with occluded cranial vessels. Multivariate analysis showed that Ibil levels were significantly higher in patients with severe stenosis group than in those with mild stenosis (OR, 1.464;95% CI, 1.050 - 2.042;P = 0.024). However, Ibil levels were significantly lower in patients with occlusion than in those with severe stenosis (OR, 0.790;95% CI, 0.684 - 0.913;P = 0.001). Conclusions: Ibil appears to have a protective effect against the development of atherosclerotic stenosis in intracranial or extracranial arteries. The biosynthesis of Ibil increases with stenosis progresses but decreases once occlusion occurs.
文摘目的：探讨长期服用氯氮平的慢性精神分裂症患者颈部、颅内动脉粥样硬化病变状况。方法将研究对象分为3组：50例健康人群为对照组，50例慢性精神分裂症服用氯丙嗪（5～10年）患者为氯丙嗪组，50例慢性精神分裂症服用氯氮平（5～10年）患者为氯氮平组。颈动脉超声和经颅多普勒超声检测颈动脉、颅内动脉粥样硬化状况；测定空腹血糖（FPS）、血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、氧化修饰低密度脂蛋白（ox-LDL）。结果氯氮平组患者颈动脉内-中膜增厚、斑块形成及狭窄发生率均明显高于对照组和氯丙嗪组（P ＜0．05或 P ＜0．01）；颅内动脉狭窄发生率明显高于对照组（P ＜0．05）。氯氮平组与氯丙嗪组血 FPS、TG、TC、LDL、ox-LDL 水平明显高于对照组（P ＜0．05或 P ＜0．01），氯氮平组明显高于氯丙嗪组（P ＜0．05或 P ＜0．01）。结论长期服用氯氮平的慢性精神分裂症患者颈部、颅内动脉可发生不同程度的粥样硬化病变，可能与其引起的血脂异常、血糖升高及抗氧化能力降低有关。
