Lying-Tunell U, Lindblad B S, Malmlund H O, Persson B
Acta Neurol Scand. 1981 Jun;63(6):337-50. doi: 10.1111/j.1600-0404.1981.tb00788.x.
The cerebral blood flow (CBF) and cerebral metabolic rate (CMR) of oxygen, glucose, lactate, pyruvate, ketone bodies and 24 amino acids were examined in 12 patients with presenile dementia and in seven with normal-pressure hydrocephalus. Both groups of patients showed significantly lower values of CBF and cerebral uptake of oxygen and glucose than 10 healthy subjects examined concurrently. The values decreased roughly in proportion to the degree of clinical deterioration. Furthermore, the patients exhibited a significant release of lactate and pyruvate. A positive correlation was found between CMR and arterial concentration of ketone bodies. The group with presenile dementia showed no uptake of amino acids, but a significant release of phenylalanine; in addition, CMR of alanine and threonine was significantly lower than in the healthy subjects. These findings suggest a cerebral catabolic state. Four patients with normal-pressure hydrocephalus were also studied after shunt operations. All showed an increase of CMR glucose and a decrease of CMR ketone bodies, acetoacetate as well as D-beta-hydroxybutyrate, which could not be attributed to a consistent decrease of arterial levels of ketone bodies.
对12例早老性痴呆患者和7例正常压力脑积水患者的脑血流量（CBF）以及氧、葡萄糖、乳酸、丙酮酸、酮体和24种氨基酸的脑代谢率（CMR）进行了检测。与同时检测的10名健康受试者相比，两组患者的CBF以及脑对氧和葡萄糖的摄取量均显著降低。这些数值大致与临床病情恶化程度成比例下降。此外，患者出现了乳酸和丙酮酸的显著释放。发现CMR与酮体的动脉浓度之间呈正相关。早老性痴呆组患者未摄取氨基酸，但苯丙氨酸有显著释放；此外，丙氨酸和苏氨酸的CMR显著低于健康受试者。这些发现提示存在脑分解代谢状态。还对4例正常压力脑积水患者在进行分流手术后进行了研究。所有患者的CMR葡萄糖均升高，CMR酮体、乙酰乙酸以及D-β-羟丁酸均降低，这不能归因于酮体动脉水平的持续下降。
