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目的建立乙酰唑胺（ＡＣＺ）负荷试验的方法及脑血流量变化的正常值，提出评价脑血管储备功能的指标。方法正常对照者６例，脑血管疾病（ＣＶＤ）患者４３例。用９９ｍＴｃ乙撑双半胱氨酸二乙酯（ＥＣＤ）先做基态脑血流（ＣＢＦ）及ＳＰＥＣＴ显像，３６～４８小时后做负荷显像（静脉注射ＡＣＺ１ｇ，２０分钟后按基态同样条件进行）。病人均有ＣＴ检查，部分有ＭＲＩ、经颅多普勒超声（ＴＣＤ）、ＤＳＡ检查。７例病人治疗后进行了随访并复查脑ＳＰＥＣＴ显像。图像分析：①视觉分析。比较ＡＣＺ试验前后的变化，分为三型：Ａ型，反应差，ＡＣＺ试验后出现病变（Ａ１）或病变扩大（Ａ２）；Ｂ型，反应好，病变缩小或消失；Ｃ型，无反应；②半定量分析：计算颈动脉及大脑半球峰时、半球血流占全脑血流百分数；计算ＡＣＺ试验前后病变区及病侧半球血流量增加率（Δ％）及放射性摄取比值（ＵＲ）。结果①正常对照两侧比较各值无差别。ＡＣＺ试验后全脑Δ％为２５０７％±８０９％，ＡＣＺ试验前后各区ＵＲ均＞０９０１。②３２例短暂性缺血发作（ＴＩＡ）脑ＣＢＦ显像４２％有闭塞性脑血管病变，与ＴＣＤ、ＤＳＡ结果相符。③ＡＣＺ试验提高了ＴＩＡ和小梗塞灶的阳性率，前者由５９３７％升至?
OBJECTIVE To establish the method of acetazolamide (ACZ) stress test and the normal value of cerebral blood flow changes, and to put forward the evaluation index of cerebrovascular reserve function. Methods 6 cases of normal control, cerebrovascular disease (CVD) in 43 cases. Baseline cerebral blood flow (CBF) and SPECT imaging were performed with 99mTc-ethylenedicarbocysteine diethyl ester (ECD). Load imaging was performed 36 to 48 hours after intravenous injection (ACZ 1g, 20 minutes after the same ground state Conditions). Patients have CT examination, some MRI, transcranial Doppler ultrasound (TCD), DSA examination. Seven patients were followed up after treatment and review of brain SPECT imaging. Image Analysis: ① visual analysis. The changes of ACZ before and after the test were divided into three types: type A, poor response, pathological changes (A1) or enlarged lesions (A2) after ACZ test; type B, response was good, lesions reduced or disappeared; (2) Semi-quantitative analysis: When calculating the carotid artery and hemispheric peak, hemispheric blood flow accounted for the percentage of total cerebral blood flow. The increase rate of blood flow (%) and radioactivity uptake (UR) in the lesion and the hemisphere before and after ACZ test were calculated. Results ①No difference was found between the two sides of normal control. After ACZ test, the whole brain Δ% was 2507% ± 809%. Before and after ACZ test, the UR values of all the areas were> 0901. ② 32 cases of transient ischemic attack (TIA) brain CBF imaging 42% had occlusive cerebrovascular disease, consistent with the TCD, DSA results. ③ ACZ test increased the positive rate of TIA and small infarction, the former rose from 59 37%?