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尤瑞克林对急性脑梗死脑血流灌注显像的影响 被引量:4

Cerebral blood flow perfusion images on CT scan after urinary kininogenase treatment in patients with acute ischemic stroke
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摘要 目的 应用多层螺旋CT灌注成像技术,观察尤瑞克林治疗对急性脑梗死中心区域及半暗带区域脑血流灌注的影响.方法 60例发病6~24 h临床诊断为急性脑梗死的患者随机分为药物组与对照组,每组各30例,对照组采用基础治疗方法,药物组在基础治疗的同时应用尤瑞克林治疗.分别于发病第1天,第10~14天行常规CT平扫及CT灌注成像检查,CT灌注成像的指标包括脑血流量(CBF)、脑血容量(CBV)及达峰时间(TTP),同时比较急性脑梗死患者治疗前后神经功能缺损状态变化.结果 (1)药物组脑梗死中心区域治疗后脑灌注成像rCBF值(0.92±1.04)较治疗前(0.59±0.42)明显升高,与对照组治疗后rCBF值(0.39±0.12)比较差异有统计学意义(P<0.05).(2)药物组脑梗死半暗带区域治疗后脑灌注成像CBV绝对值(49.65±27.24 )ml/100g较治疗前(31.32±18.26)ml/100g明显升高,与对照组治疗后(31.60±34.10)ml/100g比较差异有统计学意义(P<0.05).(3)药物组脑梗死半暗带区域治疗后脑灌注成像rCBF值(3.12±2.76)较治疗前(2.76±1.78)明显升高,与对照组治疗后rCBF值(0.30±0.57)比较差异有统计学意义(P<0.05).(4)药物组脑梗死半暗带区域治疗后脑灌注成像rCBV值(2.67±3.46)与对照组治疗后rCBV值(0.47±0.58)比较差异有统计学意义(P<0.05).结论 急性脑梗死应用尤瑞克林治疗后能有效改善脑梗死中心区域及半暗带区域的血液灌注,其中半暗带区域改变尤为明显,表现为rCBF、rCBV值明显升高. Objective To evaluate the cerebral blood flow perfusion images on CT scan after urinary kininogenase treatment in patients with acute ischemic stroke. Methods Sixty patients with cerebral infarction were randomly assigned to receive urinary kininogenese treatment( drug group, n=30) on conventional treatment (control group, Х^2=30). All patients underwent routine CT and CT perfusion imaging (CTPI) at dl and dlO - 14;the CTPIs with cerebral blood flow (CBF), cerebral blood volume (CBF) and time to peak (TIP) were observed and evaluated. The scores of neurologic impairment before and after treatment were also evaluated. Results The rCBF of brain perfusion imaging at the central zone of cerebral infarction after drug treatment were significantly higher than that before treatment (0.92 ±1.04 vs 0.59 ± 0.42, P〈0.05 ) and that of control group (0.92 ±1.04 vs 0.39 ± 0.12,P〈0.05). The CBV of brain perfusion imaging at the semidarkness zone of cerebral infarction after treatment in drug group was significantly higher than that before treatment (49.65 ± 27.24ml/100g vs 31.32 ±18.26ml/100g, P〈0.05) and that of control group (49.65 ± 27.24ml/100g vs 31.60 ± 34.10ml/100g, P〈0.05). The rCBF at the semidarkness zone of cerebral infarction after treatment was significantly higher than that before treatment in drug group (3.12 ±2.76 vs 2.76± 1.78, P〈0.05), and that in control group (3.12±2.76 vs 0.30± 0.57, P〈0.05). The rCBV at the semidarkness zone of cerebral infarction after treatment in drug group was significantly higher than that in control group (2.67± 3.46 vs 0.47 ± 0.58, P〈0.05). Conclusion Urinary kininogenase can improve the cerebral blood flow perfusion at the central and semidarkness zone in acute ischemic stroke.
作者 张友定
出处 《浙江医学》 CAS 2012年第11期894-896,共3页 Zhejiang Medical Journal
基金 浙江省舟山市年斗技局基金项目2008106
关键词 尤瑞克林 急性脑梗死 灌注成像 脑血流量 脑血容量 达峰时间 Acute ischemic stroke Urinary kininogenase Perfusion imaging Cerebral blood flow(CBF) Cerebral blood volume(CBV) Time to peak(FrP)
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