Mampunza S, Verbanck P, Verhas M, Martin P, Paternot J, Le Bon O, Kornreich C, Den Bulk A, Pelc I
Clinique d'Alcoologie et Toxicomanie, Hôpital Universitaire Brugmann Université Libre de Bruxelles.
Acta Neurol Belg. 1995;95(3):164-9.
Chronic alcohol abuse is responsible for several organic brain disorders. However, even the most characteristic of them are largely underdiagnosed by routine procedures. Therefore, there is need for sensitive, noninvasive and low-cost diagnostic procedures. 99m-Tc-HMPAO-SPECT could be an interesting candidate in this indication, because it estimates the distribution of the cerebral blood flow and the metabolic activity of the brain with a good resolution. We used this technique in 17 healthy volunteers and in a sample of 50 patients dependent on alcohol, without other major physical or mental disorder. SPECT was performed during the attendance of these patients in an inpatient detoxification program. We observed abnormal SPECT in 34 patients, but only in 2 volunteers (p < 0.001). The main abnormality was heterogeneity of the distribution of the tracer. SPECT abnormalities appear to be due nor to withdrawal syndrome, nor to medication. On the contrary, they are correlated with stigmata of heavy alcoholism. Furthermore, a genetic vulnerability to alcohol was suspected because SPECT abnormalities are more frequent in patients with an history of drinking problems in their relatives.
长期酗酒会引发多种器质性脑疾病。然而，即便其中最具特征性的疾病，通过常规检查也大多难以确诊。因此，需要灵敏、无创且低成本的诊断方法。99m锝-六甲基丙二胺肟单光子发射计算机断层扫描（99m-Tc-HMPAO-SPECT）可能是适用于此症的理想选择，因为它能以良好的分辨率评估脑血流分布及大脑代谢活性。我们对17名健康志愿者以及50名酒精依赖患者（无其他重大身心疾病）进行了此项技术检测。单光子发射计算机断层扫描在这些患者住院戒酒治疗期间进行。我们发现34名患者存在SPECT异常，但只有2名志愿者出现异常（p < 0.001）。主要异常表现为示踪剂分布不均。SPECT异常似乎既非由戒断综合征引起，也与药物无关。相反，它们与重度酒精中毒的体征相关。此外，由于有亲属饮酒问题病史的患者中SPECT异常更为常见，因此怀疑存在酒精遗传易感性。
