HUMAN FOCAL CEREBRAL-ISCHEMIA - EVALUATION OF BRAIN PH AND ENERGY-METABOLISM WITH P-31 NMR-SPECTROSCOPY
HUMAN FOCAL CEREBRAL-ISCHEMIA - EVALUATION OF BRAIN PH AND ENERGY-METABOLISM WITH P-31 NMR-SPECTROSCOPY
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DOI：
10.1148/radiology.185.2.1410369
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发表时间：
1992-11-01
期刊：
影响因子：
19.7
通讯作者：
ORDIDGE, RJ
中科院分区：
文献类型：
--
作者：
LEVINE, SR;HELPERN, JA;ORDIDGE, RJ
作者采用1.89 T的磷-31核磁共振波谱研究了早期人局灶性缺血，以表征脑pH和磷酸盐能量代谢的时间演变和关系。对65例有症状患者的数据进行了前瞻性研究，这些患者之前均未发生过颈内动脉供血区缺血性卒中。28名神经系统正常的人作为对照组。连续缺血性脑pH值水平表明从早期酸中毒进展为亚急性酸中毒。与对照组相比，酸中毒时无机磷酸盐（Pi）的相对信号强度显著升高，α-三磷酸腺苷（ATP）和γ-ATP的信号强度显著降低。缺血脑pH值与磷酸肌酸（PCr）的相对信号强度和PCr指数直接相关，与Pi的信号强度呈负相关。缺血性脑pH或磷酸盐能量代谢与初始临床卒中严重程度之间普遍缺乏相关性。这些数据表明高能磷酸盐代谢和脑pH值之间存在联系，特别是在缺血性脑酸中毒期间，作者建议在此期间应制定有效的急性卒中治疗。
The authors investigated early human focal ischemia with phosphorus-31 nuclear magnetic resonance spectroscopy at 1.89 T to characterize the temporal evolution and relationship of brain pH and phosphate energy metabolism. Data from 65 symptomatic patients were prospectively studied; none of the patients had had ischemic stroke in the internal carotid artery territory before. Twenty-eight neurologically normal individuals served as control subjects. Serial ischemic brain pH levels indicated a progression from early acidosis to subacute alkalosis. When acidosis was present there was a significant elevation in the relative signal intensity of inorganic phosphate (Pi) and significant reductions in signal intensities of alpha-adenosine triphosphate (ATP) and gamma-ATP compared with those of control subjects. Ischemic brain pH values directly correlated with the relative signal intensity of phosphocreatine (PCr) and the PCr index and inversely correlated with the signal intensity of Pi. There was a general lack of correlation between either ischemic brain pH or phosphate energy metabolism and the initial clinical stroke severity. The data suggest a link between high-energy phosphate metabolism and brain pH, especially during the period of ischemic brain acidosis, and the authors propose that effective acute stroke therapy should be instituted during this period.