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目的：探讨液压冲击脑损伤后脑血流量（ＣＢＦ），局部脑血流量（ｒＣＢＦ）与局部葡萄糖利用率（ｒＣＧＵ）的变化及其对神经元继发性损伤的影响。方法：应用激光多普勒流量计和定量放射自显影技术。结果：液压冲击脑损伤导致６０秒内ＣＢＦ短暂升高然后显著下降，且持续６０分钟低于正常，同侧和对侧大脑半球的ＣＢＦ相应降为正常值的７９％和９３％。外伤后１小时，损伤侧脑皮层，丘脑及海马的ｒＣＢＦ下降１２％～５９％，对侧大脑半球相应区域则下降１０％～４０％。相反，ｒＣＧＵ在冲击区周围脑皮质及同侧丘脑和海马区升高２７％～１０１％，在对侧大脑半球相应区域则升高２０％～９１％，海马区由液压冲击引起的ｒＣＢＦ和ｒＣＧＵ分离性变化十分显著，同侧海马ＣＡ１和ＣＡ２－３区存活的神经元数量在损伤后两星期时显著减少。结论：ｒＣＢＦ和ｒＣＧＵ的分离性变化是引起外伤后神经元尤其是海马区神经元继发损伤的主要因素。
Objective: To investigate the changes of cerebral blood flow (CBF), regional cerebral blood flow (rCBF) and local glucose utilization (rCGU) and its effect on secondary neuronal injury after fluid percussion injury. Methods: Laser Doppler flowmetry and quantitative autoradiography were used. RESULTS: The fluid-percussion brain injury resulted in a transient increase in CBF within 60 seconds followed by a significant decrease in CBF for the ipsilateral and contralateral hemispheres to 79% and 93% of normal for 60 minutes, respectively. One hour after trauma, the rCBF decreased 12% -59% in the lesion side cortex, thalamus and hippocampus, and decreased 10% -40% in the contralateral hemisphere corresponding area. In contrast, rCGU increased by 27% -101% in the cerebral cortex and ipsilateral thalamus and hippocampus around the impact zone and by 20% -91% in the corresponding region of the contralateral hemisphere. The rCBF and rCGU Separation of changes is very significant, ipsilateral hippocampal CA1 and CA2-3 area survival of neurons in the two weeks after injury significantly reduced. Conclusion: The changes of rCBF and rCGU are the main factors that cause the secondary damage of neurons in traumatic brain, especially in hippocampus.