Chang C C, Kuwana N, Ito S, Ikegami T
Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Japan.
Nucl Med Commun. 2000 Feb;21(2):139-41. doi: 10.1097/00006231-200002000-00003.
Cerebrovascular reactivity (CVR) to acetazolamide was investigated in 41 patients with normal pressure hydrocephalus (NPH). The aetiology was subarachnoid haemorrhage in 20 patients, trauma in nine, brain tumour in three and idiopathic in nine. Mean cerebral blood flow (CBF) of the whole brain was measured by performing first-pass radionuclide angiography using 99Tcm-hexamethylpropylene++ amine oxime. Cerebrovascular reactivity was measured as the percentage change from the baseline mean CBF value after the administration of 500 mg of acetazolamide. Cerebrovascular reactivity was significantly (P < 0.001) reduced in patients with the complete triad of NPH (1.4 +/- 3.1%), regardless of the aetiology, compared with normal controls (14.7 +/- 3.3%). Patients with the incomplete triad also showed significantly (P < 0.05) reduced CVR (9.6 +/- 5.4%). Patients with the complete triad had significantly (P < 0.001) lower CVR than those with the incomplete triad. Post-operative CVR in both groups (20 patients with the complete triad and 9 patients with the incomplete triad) increased significantly, from 1.5 +/- 3.5% to 10.0 +/- 5.5% (P < 0.001) and from 8.7 +/- 4.9% to 14.9 +/- 5.4% (P < 0.05), respectively. Cerebrovascular reactivity is impaired in patients with NPH regardless of the aetiology and improves after shunting.
对41例正常压力脑积水（NPH）患者进行了乙酰唑胺的脑血管反应性（CVR）研究。病因方面，20例为蛛网膜下腔出血，9例为创伤，3例为脑肿瘤，9例为特发性。通过使用99Tcm - 六甲基丙烯胺肟进行首次通过放射性核素血管造影测量全脑平均脑血流量（CBF）。脑血管反应性通过给予500mg乙酰唑胺后相对于基线平均CBF值的百分比变化来测量。无论病因如何，NPH完全三联征患者的脑血管反应性均显著降低（P < 0.001），为1.4±3.1%，而正常对照组为14.7±3.3%。不完全三联征患者的CVR也显著降低（P < 0.05），为9.6±5.4%。完全三联征患者的CVR显著低于不完全三联征患者（P < 0.001）。两组（20例完全三联征患者和9例不完全三联征患者）术后CVR均显著增加，分别从1.5±3.5%增至10.0±5.5%（P < 0.001）和从8.7±4.9%增至14.9±5.4%（P < 0.05）。无论病因如何，NPH患者的脑血管反应性均受损，分流术后改善。
