血清C-反应蛋白、氢质子磁共振波谱与脑梗死的关系
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摘要
目的：研究脑梗死患者血清C-反应蛋白(C-reactive protein，CRP)、氢质子磁共振波谱(proton magnetic reasonance spectroscopy，~1HMRS)与脑梗死的关系及二者间的相互关系。
方法：对病程在两周以内的30例脑梗死患者在入院时测定CRP，对病灶中心区行~1HMRS分析，测定卒中体积，应用美国国立卫生研究院卒中量表(national institutes of health stroke scale，NIHSS)在患者入院及治疗后3个月时进行神经功能缺损程度评分。
结果：CRP和~1HMRS中的N-乙酰天门冬氨酸(N-acetyl aspartate，
NAA)与NHISS_1，NHISS_2，卒中体积显著相关，且二者有统计学相关性。而~1HMRS中的乳酸(lactic acid，Lac)与NHISS_1，NHISS_2，卒中体积无相关性。
结论：CRP与NAA均可对脑梗死病情及预后作出判断，且二者之间具有统计学相关性。
Objective: To study the relationships between C-reactive protein (CRP), proton magnetic reasonance spectroscopy (~1HMRS) and cerebral infaction。
Methods: The CRP, ~1HMRS and volume of cerebral infarction were determined at admission in 30 patients with cerebral infarction within 2 weeks after symptom onset. The deficiency intensity of neuro function was evaluated at admission (NHISS_1) and following up 3 months after admission (NHISS_2).
Results: CRP and N-acetyl aspartate (NAA) were significantly correlated with NHISS_1, NHISS_2 and the volume of cerebral infarction, what s more, they also have significant correlation. But lactic acid(Lac) has no correlation with with NHISS_1, NHISS_2 and the volume of cerebral infarction.
Conclusion: Both CRP and NAA can predict the severity and prognosis in cerebral infarction, they have correlation with each other in statistics.
方法：对病程在两周以内的30例脑梗死患者在入院时测定CRP，对病灶中心区行~1HMRS分析，测定卒中体积，应用美国国立卫生研究院卒中量表(national institutes of health stroke scale，NIHSS)在患者入院及治疗后3个月时进行神经功能缺损程度评分。
结果：CRP和~1HMRS中的N-乙酰天门冬氨酸(N-acetyl aspartate，
NAA)与NHISS_1，NHISS_2，卒中体积显著相关，且二者有统计学相关性。而~1HMRS中的乳酸(lactic acid，Lac)与NHISS_1，NHISS_2，卒中体积无相关性。
结论：CRP与NAA均可对脑梗死病情及预后作出判断，且二者之间具有统计学相关性。
Objective: To study the relationships between C-reactive protein (CRP), proton magnetic reasonance spectroscopy (~1HMRS) and cerebral infaction。
Methods: The CRP, ~1HMRS and volume of cerebral infarction were determined at admission in 30 patients with cerebral infarction within 2 weeks after symptom onset. The deficiency intensity of neuro function was evaluated at admission (NHISS_1) and following up 3 months after admission (NHISS_2).
Results: CRP and N-acetyl aspartate (NAA) were significantly correlated with NHISS_1, NHISS_2 and the volume of cerebral infarction, what s more, they also have significant correlation. But lactic acid(Lac) has no correlation with with NHISS_1, NHISS_2 and the volume of cerebral infarction.
Conclusion: Both CRP and NAA can predict the severity and prognosis in cerebral infarction, they have correlation with each other in statistics.
引文
1．彭洪娟，赵斌．~1HMRS基本原理及成像技术．医学影像学杂志2004，14(12)：1033
2. Lanfermann H, Kugel H, Heindel w, et al. Metabolic changes in acute and subacute cerebral infarctiongs: findings at proton MR spectroscopic imaging. Radiology 1995, 196: 203-210
3. Mathews VP, Barker PB, Blackband SJ, et al. Cerebral metabolites in patients with acute and subacute strokes: concentrations determined by quantitative proton MR spectroscopy. AJNR 1995, 165:633-638
4. Barker PB, Gillard JH, van Zijl PCM, et al. Acute Stroke.- evaluation with serial proton MR spectroscopic imaging. Radiology 1994, 192:723-732
5. Dujin JH, Matson GB, Mandsley AA, et al. Human brain infarction: proton MR spectroscopy. Radiology 1992, 183: 711-718
6. Parsons MW, Li T, Barber PA, et al. Combined ~1H MR spectroscopy and diffusion-weighted MRI improves the prediction of stroke outcome. Neurology 2000, 55(4): 498-505
7. Graham GD, Kalvaoh P, Blamire AM, et al. Clinical correlates of proton magnetic resonance spectroscopy findings after acute cerebral infarction. Stroke 1995, 26(2): 225-9
8．郭毅，周志斌，姜昕等．急性脑梗死患者颈动脉硬化斑块与血清C反应蛋白及白细胞计数的意义．临床神经病学杂志2003，16：266
9．高亮．C反应蛋白在急性脑梗死发病中作用机制的探讨．山西医药杂志2004，33(6)：475
10．曹红，孙长凯，赵耿毅等．C反应蛋白水平与预后的量化研究．中国现代神经疾病杂志2005，5(2)：84-87
11. Audebert HJ, Rott MM, Eck T, et al. Systemic inflammatory response depends on initial stroke severity but is attenuated by successful thrombolysis. Stroke 2004, 35(9): 2128-33
12．中华神经科学会，中华神经外科学会．各类脑血管疾病诊断要点．中华神经科杂志1996，29：379-380．
13. Nicoli f, Lefur Y, Denis B, et al. Metabolic counterpart of decreased apparent diffusion coefficient during hyperacute ischemic stroke: a brain proton magnetic resonace spectroscopic imaging study. Stroke 2003, 34: e82-e87
14．贾滕蛟．急性缺血性脑梗死的~1HMRS表现．神经放射学2002，25：3
15. Kothari RU, Brott T, Broderick JP, et al. The ABCs of measuring intracerebral??hemorrhage volumes. Stroke 1996, 27:1304-1305
16. Emsley HC, Tyrrell PJ. Inflammation and infection in clinical stroke. Cereb Blood Flow Metab 2002, 22(12): 1399-1419
17. Winbeck K, Poppert H, Etgen T, et al. Prognostic relevance of early serial C-reactive protein measurements after ischemic stroke. Stroke 2002, 33(10): 2459-2464
18．陈晋文，张改华，谢仁厚等．脑梗死患者C反应蛋白水平测定的临床意义．Clin Neurol 2005，18(3)：206
19. Dziedzic T, Gryz EA, Turaj W, et al. Serum interleukin-6 soluble receptor in relation to interleukin-6 in stroke patients. Mol Neurosci 2004, 24: 293-298
20. Chan Carusone S, Smieja M, Molloy W, et al. Lack of association between vascular dementia and Chlamydia pneumoniae infection: a case-control study. BMC Neurol 2004, 4: 15
21. Yasojima K, Schwab C, McGeer EG, et al. Generation of C-reactive protein and complement components in atherosclerotic plaques. Am J Pathol 2001, 158: 1039-1051
22．邱炳辉．磁共振波谱在癫痫疾病中的临床应用．国外医学神经病神经外科学分册2001，28(2)：118-121
23. Dunlop DS, Mc-Hale DM, Lajtha A. Decreased brain N-acetylaspartate in Huntington's disease. Brain Res 1992, 580: 44
24. Federico F, Simine IL, Luciverov, et al. Prognostic value of proton magnetic resonance spectroscopy in ischemic stroke. Arch Neurol 1996, 5(4): 489-94
25. Wild JM, Marshall Ⅰ. Normalisation of metabolite images in ~1H NMR spectroscopic imaging. Magn Reson Imaging 1997, 15(9): 1057-66
26. Stengel A, Neumann-Haefelin T, Singer DC, et al. Multiple spin-echo spectroscopic imaging for rapid quantitative assessment of N-acetylaspartate and lactate in acute stroke. Magn Reson Med 2004, 52(2): 228-38
27. Wardlaw JM, Marshall I, Wild J, et al. Studies of acute ischemic stroke with proton magnetic resonace spectroscopy: relation between time from onset, neurological deficit, metabolite abnormalities in the infarct, blood flow and clinical outcome. Stroke 1998, 29(8): 1618-24
28. Schiemanck SK, Post MW, Kwakkel G, et al. Ischemic lesion volume correlates with long-term functional outcome and quality of life of middle cerebral artey stroke survivors. Restor Neurol Neurosci 2005, 23(3-4): 257-631．彭洪娟，赵斌．~1HMRS基本原理及成像技术．医学影像学杂志2004，14(12)：1033
2. Lanfermann H, Kugel H, Heindel w, et al. Metabolic changes in acute and subacute cerebral infarctions., findings at proton MR spectroscopic imaging. Radiology 1995, 196: 203-210
3. Mathews VP, Barker PB, Blackband SJ, et al. Cerebral metabolites in patients with acute and subacute strokes: concentrations determined by quantitative proton MR spectroscopy. AJNR 1995, 165: 633-638
4. Barker PB, Gillard JH, van Zijl PCM, et al. Acute Stroke.. evaluation with serial proton MR spectroscopic imaging. Radiology 1994, 192: 723-732
5. Dujin JH, Matson GB, Mandsley AA, et al. Human brain infarction: proton MR spectroscopy. Radiology 1992, 183: 711-718
6. Parsons MW, Li T, Barber PA, et al. Combined 1H MR spectroscopy and diffusion-weighted MR! improves the prediction of stroke outcome. Neurology 2000, 5(4): 498-505
7. Graham GD, Kalvaoh P, Blamire AM, et al. Clinical correlates of proton magnetic resonance spectroscopy findings after acute cerebral infarction. Stroke 1995, 26(2): 225-9
8．郭毅，周志斌，姜听等．急性脑梗死患者颈动脉硬化斑块与血清C反应蛋白及白细胞计数的意义．临床神经病学杂志2003，16：266
9．高亮．C反应蛋白在急性脑梗死发病中作用机制的探讨．山西医药杂志2004，33(6)：475
10．曹红，孙长凯，赵耿毅等．C反应蛋白水平与预后的量化研究．中国现代神经疾病杂志2005，5(2)：84-87
11. Audebert HJ, Rott MM, Eck T, et al. Systemic inflammatory response depends on initial stroke severity but is attenuated by successful thrombolysis. Stroke 2004, 35(9): 2128-33
12. Emsley HC, Tyrrell PJ. Inflammation and infection in clinical stroke. Cereb Blood Flow Metab 2002, 22(12): 1399-1419
13. Winbeck K, Poppert H, Etgen T, et al. Prognostic relevance of early serial C-reactive protein measurements after ischemic stroke. Stroke 2002, 33(10): 2459-246414. Chan Carusone S, Smieja M, Molloy W, et al. Lack of association between vascular dementia and Chlamydia pneumoniae infection: a case-control study. BMC Neurol 2004, 4: 15
15. Yasojima K, Schwab C, McGeer EG, et al. Generation of C-reactive protein and complement components in atherosclerotic plaques. Am J Pathol 2001, 158: 1039-1051
16. Iring Kushner, Debra Rzewnicki, David Samols. What Does Minor Elevation of C-Reactive Protein Signify? The American Journal of Medicine 2006, 166, e17-e28
17．陈晋文，张改华，谢仁厚等．脑梗死患者C反应蛋白测定的临床意义．ClinNeurol2005，18(3)：206
18．邱炳辉．磁共振波谱在癫痫疾病中的临床应用．国外医学神经病神经外科学分册2001，28(2)：118-121
19. Dunlop DS, Mc-Hale DM, Lajtha A. Decreased brain N-acetyl aspartate in Huntington's disease. Brain Res 1992, 580: 44
20. Nicoli f, Lefur Y, Denis B, et al. Metabolic counterpart of decreased apparent diffusion coefficient during hyperacute ischemic stroke: a brain proton magnetic resonace spectroscopic imaging study. Stroke 2003, 34: e82-e87
21．贾滕蛟．急性缺血性脑梗死的~1HMRS表现．神经放射学2002，25：3
22. Miller BL. A review of chemical issues in ~1H NMR spectroscopy: N-acetyl-L-aspartate, creatine and choline. NMR Biomed 1991, 4: 47
23．王维治．神经病学．第五版．
24. Wild JM, Marshall I. Normalization of metabolite images in 1H NMR spectroscopicimaging. MagnResonlmaging 1997, 15(9): 1057-66
25. Federico F, Simone IL, Luciverov, et al. Prognostic value of proton magnetic resonance spectroscopy in ischemic stroke. Arch Neurol 1998, 55(4): 489-94
26. Kamada K, Houkin K, Iwasaki Y, et al. Metabolic and neurological patterns in chronic cerebral infarction: a single-voxel 1H-MR spectroscopy study. Neuroradiology 1997, 39(8): 560-5
27. Saunders DE, Howe FA, van den Boogaart A, et al. Continuing ischemic damage after acute middle cerebral artery infarction in humans demonstrated by short-echo proton spectroscopy. Stroke 1995, 26(6): 1007-13
28. Stengel A, Neumann-Haefelin T, Singer OC, et al. Multiple spin-echo spectroscopic imaging for rapid quantitative assessment of N-acetyl aspartate and Lactate in??acute stroke. Magn Reson Med 2004, 52(2): 228-38
29. Lythgoe D, Simmons A, Pereira A, et al. Magnetic resonance makers of ischaemia: their correlation with vasodilatory reserve in patients with carotid artery stenosis and occlusion. Jneurol Neurosurg Psychiatry 2001, 71(1): 58-62
30. Kamada K, Takeuchi F, Houkin K, et al. Reversible brain dysfunction in MELAS: MEG and (1)HMRS analysis. Neurol Neurosurg Psychiatry 2001, 70(5): 675-8
31. Gideon P, Sperling A, Pereira A, et al. Magnetic resonance makers of ischemia: their correlation with vasodilatory reserve in patients with carotid artery stenosis and occlusion. NeurolNeurosurg Psychiatry 2001, 71(1): 58-62
32. Igarashi H, Kwee IL, Okubo S, et al. Predicting the pathological fate of focal cerebral ischemia using 1H-magnetic resonance spectroscopic imaging. International Congress Series 2003, 1252: 341-344
33．钟士江，谢鹏，方维东等．超急性脑梗死的磁共振波谱分析．重庆医科大学学报2004，29(4)：474
34. Graham GD, Hwang JH, Rothman DL, et al. Spectroscopic assessment of alteration in marcromolecule and small-molecule metabolites in human brain after stroke. Stroke 2001, 32(12): 2797-2802
35. Lauriero F, Federico F, Rubini G, et al. 99Tcm-HMPAO SPET and 1H-MRS in patients with ischemic cerebral infarction. Nucl Med Commun 1996, 17(2): 140-6
36. Gillard JH, Barker PB, van Zijl PC, et al. Proton MR spectroscopy in acute middle cerebral artery stroke. AJNRAM J Neuroradiol 1996, 17(5): 873-86
37. Gideon P, Henriksen O, Sperling B, et al. Early time course of N-acetyl aspartate, creatine and phosphocreatine, and compounds containing choline in the brain after acute stroke. Stroke 1992, 23(11): 1566-1572
38. Rumpel H, Khoo JB, Chand HM, et al. Correlation of apparent diffusion coefficient and the creatine level in early ischemic stroke: a comparison of different patterns by magnetic resonance. Magn Reson 2001, 13(3): 335-343
2. Lanfermann H, Kugel H, Heindel w, et al. Metabolic changes in acute and subacute cerebral infarctiongs: findings at proton MR spectroscopic imaging. Radiology 1995, 196: 203-210
3. Mathews VP, Barker PB, Blackband SJ, et al. Cerebral metabolites in patients with acute and subacute strokes: concentrations determined by quantitative proton MR spectroscopy. AJNR 1995, 165:633-638
4. Barker PB, Gillard JH, van Zijl PCM, et al. Acute Stroke.- evaluation with serial proton MR spectroscopic imaging. Radiology 1994, 192:723-732
5. Dujin JH, Matson GB, Mandsley AA, et al. Human brain infarction: proton MR spectroscopy. Radiology 1992, 183: 711-718
6. Parsons MW, Li T, Barber PA, et al. Combined ~1H MR spectroscopy and diffusion-weighted MRI improves the prediction of stroke outcome. Neurology 2000, 55(4): 498-505
7. Graham GD, Kalvaoh P, Blamire AM, et al. Clinical correlates of proton magnetic resonance spectroscopy findings after acute cerebral infarction. Stroke 1995, 26(2): 225-9
8．郭毅，周志斌，姜昕等．急性脑梗死患者颈动脉硬化斑块与血清C反应蛋白及白细胞计数的意义．临床神经病学杂志2003，16：266
9．高亮．C反应蛋白在急性脑梗死发病中作用机制的探讨．山西医药杂志2004，33(6)：475
10．曹红，孙长凯，赵耿毅等．C反应蛋白水平与预后的量化研究．中国现代神经疾病杂志2005，5(2)：84-87
11. Audebert HJ, Rott MM, Eck T, et al. Systemic inflammatory response depends on initial stroke severity but is attenuated by successful thrombolysis. Stroke 2004, 35(9): 2128-33
12．中华神经科学会，中华神经外科学会．各类脑血管疾病诊断要点．中华神经科杂志1996，29：379-380．
13. Nicoli f, Lefur Y, Denis B, et al. Metabolic counterpart of decreased apparent diffusion coefficient during hyperacute ischemic stroke: a brain proton magnetic resonace spectroscopic imaging study. Stroke 2003, 34: e82-e87
14．贾滕蛟．急性缺血性脑梗死的~1HMRS表现．神经放射学2002，25：3
15. Kothari RU, Brott T, Broderick JP, et al. The ABCs of measuring intracerebral??hemorrhage volumes. Stroke 1996, 27:1304-1305
16. Emsley HC, Tyrrell PJ. Inflammation and infection in clinical stroke. Cereb Blood Flow Metab 2002, 22(12): 1399-1419
17. Winbeck K, Poppert H, Etgen T, et al. Prognostic relevance of early serial C-reactive protein measurements after ischemic stroke. Stroke 2002, 33(10): 2459-2464
18．陈晋文，张改华，谢仁厚等．脑梗死患者C反应蛋白水平测定的临床意义．Clin Neurol 2005，18(3)：206
19. Dziedzic T, Gryz EA, Turaj W, et al. Serum interleukin-6 soluble receptor in relation to interleukin-6 in stroke patients. Mol Neurosci 2004, 24: 293-298
20. Chan Carusone S, Smieja M, Molloy W, et al. Lack of association between vascular dementia and Chlamydia pneumoniae infection: a case-control study. BMC Neurol 2004, 4: 15
21. Yasojima K, Schwab C, McGeer EG, et al. Generation of C-reactive protein and complement components in atherosclerotic plaques. Am J Pathol 2001, 158: 1039-1051
22．邱炳辉．磁共振波谱在癫痫疾病中的临床应用．国外医学神经病神经外科学分册2001，28(2)：118-121
23. Dunlop DS, Mc-Hale DM, Lajtha A. Decreased brain N-acetylaspartate in Huntington's disease. Brain Res 1992, 580: 44
24. Federico F, Simine IL, Luciverov, et al. Prognostic value of proton magnetic resonance spectroscopy in ischemic stroke. Arch Neurol 1996, 5(4): 489-94
25. Wild JM, Marshall Ⅰ. Normalisation of metabolite images in ~1H NMR spectroscopic imaging. Magn Reson Imaging 1997, 15(9): 1057-66
26. Stengel A, Neumann-Haefelin T, Singer DC, et al. Multiple spin-echo spectroscopic imaging for rapid quantitative assessment of N-acetylaspartate and lactate in acute stroke. Magn Reson Med 2004, 52(2): 228-38
27. Wardlaw JM, Marshall I, Wild J, et al. Studies of acute ischemic stroke with proton magnetic resonace spectroscopy: relation between time from onset, neurological deficit, metabolite abnormalities in the infarct, blood flow and clinical outcome. Stroke 1998, 29(8): 1618-24
28. Schiemanck SK, Post MW, Kwakkel G, et al. Ischemic lesion volume correlates with long-term functional outcome and quality of life of middle cerebral artey stroke survivors. Restor Neurol Neurosci 2005, 23(3-4): 257-631．彭洪娟，赵斌．~1HMRS基本原理及成像技术．医学影像学杂志2004，14(12)：1033
2. Lanfermann H, Kugel H, Heindel w, et al. Metabolic changes in acute and subacute cerebral infarctions., findings at proton MR spectroscopic imaging. Radiology 1995, 196: 203-210
3. Mathews VP, Barker PB, Blackband SJ, et al. Cerebral metabolites in patients with acute and subacute strokes: concentrations determined by quantitative proton MR spectroscopy. AJNR 1995, 165: 633-638
4. Barker PB, Gillard JH, van Zijl PCM, et al. Acute Stroke.. evaluation with serial proton MR spectroscopic imaging. Radiology 1994, 192: 723-732
5. Dujin JH, Matson GB, Mandsley AA, et al. Human brain infarction: proton MR spectroscopy. Radiology 1992, 183: 711-718
6. Parsons MW, Li T, Barber PA, et al. Combined 1H MR spectroscopy and diffusion-weighted MR! improves the prediction of stroke outcome. Neurology 2000, 5(4): 498-505
7. Graham GD, Kalvaoh P, Blamire AM, et al. Clinical correlates of proton magnetic resonance spectroscopy findings after acute cerebral infarction. Stroke 1995, 26(2): 225-9
8．郭毅，周志斌，姜听等．急性脑梗死患者颈动脉硬化斑块与血清C反应蛋白及白细胞计数的意义．临床神经病学杂志2003，16：266
9．高亮．C反应蛋白在急性脑梗死发病中作用机制的探讨．山西医药杂志2004，33(6)：475
10．曹红，孙长凯，赵耿毅等．C反应蛋白水平与预后的量化研究．中国现代神经疾病杂志2005，5(2)：84-87
11. Audebert HJ, Rott MM, Eck T, et al. Systemic inflammatory response depends on initial stroke severity but is attenuated by successful thrombolysis. Stroke 2004, 35(9): 2128-33
12. Emsley HC, Tyrrell PJ. Inflammation and infection in clinical stroke. Cereb Blood Flow Metab 2002, 22(12): 1399-1419
13. Winbeck K, Poppert H, Etgen T, et al. Prognostic relevance of early serial C-reactive protein measurements after ischemic stroke. Stroke 2002, 33(10): 2459-246414. Chan Carusone S, Smieja M, Molloy W, et al. Lack of association between vascular dementia and Chlamydia pneumoniae infection: a case-control study. BMC Neurol 2004, 4: 15
15. Yasojima K, Schwab C, McGeer EG, et al. Generation of C-reactive protein and complement components in atherosclerotic plaques. Am J Pathol 2001, 158: 1039-1051
16. Iring Kushner, Debra Rzewnicki, David Samols. What Does Minor Elevation of C-Reactive Protein Signify? The American Journal of Medicine 2006, 166, e17-e28
17．陈晋文，张改华，谢仁厚等．脑梗死患者C反应蛋白测定的临床意义．ClinNeurol2005，18(3)：206
18．邱炳辉．磁共振波谱在癫痫疾病中的临床应用．国外医学神经病神经外科学分册2001，28(2)：118-121
19. Dunlop DS, Mc-Hale DM, Lajtha A. Decreased brain N-acetyl aspartate in Huntington's disease. Brain Res 1992, 580: 44
20. Nicoli f, Lefur Y, Denis B, et al. Metabolic counterpart of decreased apparent diffusion coefficient during hyperacute ischemic stroke: a brain proton magnetic resonace spectroscopic imaging study. Stroke 2003, 34: e82-e87
21．贾滕蛟．急性缺血性脑梗死的~1HMRS表现．神经放射学2002，25：3
22. Miller BL. A review of chemical issues in ~1H NMR spectroscopy: N-acetyl-L-aspartate, creatine and choline. NMR Biomed 1991, 4: 47
23．王维治．神经病学．第五版．
24. Wild JM, Marshall I. Normalization of metabolite images in 1H NMR spectroscopicimaging. MagnResonlmaging 1997, 15(9): 1057-66
25. Federico F, Simone IL, Luciverov, et al. Prognostic value of proton magnetic resonance spectroscopy in ischemic stroke. Arch Neurol 1998, 55(4): 489-94
26. Kamada K, Houkin K, Iwasaki Y, et al. Metabolic and neurological patterns in chronic cerebral infarction: a single-voxel 1H-MR spectroscopy study. Neuroradiology 1997, 39(8): 560-5
27. Saunders DE, Howe FA, van den Boogaart A, et al. Continuing ischemic damage after acute middle cerebral artery infarction in humans demonstrated by short-echo proton spectroscopy. Stroke 1995, 26(6): 1007-13
28. Stengel A, Neumann-Haefelin T, Singer OC, et al. Multiple spin-echo spectroscopic imaging for rapid quantitative assessment of N-acetyl aspartate and Lactate in??acute stroke. Magn Reson Med 2004, 52(2): 228-38
29. Lythgoe D, Simmons A, Pereira A, et al. Magnetic resonance makers of ischaemia: their correlation with vasodilatory reserve in patients with carotid artery stenosis and occlusion. Jneurol Neurosurg Psychiatry 2001, 71(1): 58-62
30. Kamada K, Takeuchi F, Houkin K, et al. Reversible brain dysfunction in MELAS: MEG and (1)HMRS analysis. Neurol Neurosurg Psychiatry 2001, 70(5): 675-8
31. Gideon P, Sperling A, Pereira A, et al. Magnetic resonance makers of ischemia: their correlation with vasodilatory reserve in patients with carotid artery stenosis and occlusion. NeurolNeurosurg Psychiatry 2001, 71(1): 58-62
32. Igarashi H, Kwee IL, Okubo S, et al. Predicting the pathological fate of focal cerebral ischemia using 1H-magnetic resonance spectroscopic imaging. International Congress Series 2003, 1252: 341-344
33．钟士江，谢鹏，方维东等．超急性脑梗死的磁共振波谱分析．重庆医科大学学报2004，29(4)：474
34. Graham GD, Hwang JH, Rothman DL, et al. Spectroscopic assessment of alteration in marcromolecule and small-molecule metabolites in human brain after stroke. Stroke 2001, 32(12): 2797-2802
35. Lauriero F, Federico F, Rubini G, et al. 99Tcm-HMPAO SPET and 1H-MRS in patients with ischemic cerebral infarction. Nucl Med Commun 1996, 17(2): 140-6
36. Gillard JH, Barker PB, van Zijl PC, et al. Proton MR spectroscopy in acute middle cerebral artery stroke. AJNRAM J Neuroradiol 1996, 17(5): 873-86
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