摘要
目的研究CT灌注成像评估急性缺血性脑卒中患者运用远隔肢体缺血后适应的预后价值。方法将我院收治的61例发病48h内的急性缺血性脑卒中患者随机分为治疗组(常规内科治疗联合远隔肢体缺血后适应)和对照组(常规内科治疗)。所有患者在入院时均行CT灌注检查,入院时及治疗2周后采用NIHSS量表及Barthel指数评价临床神经功能,比较治疗组与对照组基底节区的CTP参数,分析治疗前后不同CTP参数的神经功能改善程度。结果给予远隔肢体缺血后适应治疗后的患者NIHSS评分及Barthel指数的改善程度与对照组比较,差异具有统计学意义(P<0.05)。相对脑血流量(rCBF)、相对平均通过时间(rMTT)与发病时的NIHSS评分及Barthel指数无相关关系,rCBF与NIHSS评分及Barthel指数的改善程度存在正相关关系,而rMTT与NIHSS评分及Barthel指数的改善程度存在负相关关系。结论早期的CT灌注评估可以判断临床预后,远隔肢体缺血后适应对于急性缺血性脑卒中患者的神经功能缺损的改善有应用价值。
Objective To evaluate the prognostic value of CT perfusion(CTP)imaging in the assessment of distal limb ischemic postconditioning in patients with acute ischemic stroke.Methods Sixty-one patients admitted to our hospital within 48 hours of the onset of acute ischemic stroke were randomly divided into treatment group (conventional medical treatment combined with distal limb ischemic postconditioning)and control group(conventional medical treatment).All patients underwent CTP examination at admission.The National Institute of Health Stroke Scale(NIHSS)and Barthel scales were used to evaluate clinical neurological function at the time of admission and 2 weeks after the treatment.CTP parameters of the basal ganglia in the treatment and control group were compared,and the improved neural function before and after the treatment with different CTP parameters was analyzed.Results The improvement in the NIHSS and Barthel scale scores in patients treated with distal limb ischemic postconditioning was statistically significant (P<0.05).There was no correlation between relative cerebral blood flow(rCBF)and relative mean transit time(rMTT)and NIHSS and Barthel scale score at the time of onset.Positive correlation was observed between rCBF and the degree of improvement in NIHSS and Barthel scale score.Moreover ,negative correlation was observed between rMTT and NIHSS score and the degree of improvement in NIHSS and Barthel scale score.Conclusions Early CTP assessment can be used to judge clinical prognosis.Distal limb ischemic postconditioning has certain application value for the improvement of neurological deficits in patients with acute ischemic stroke.
作者
匡祖颖
向姣
张新斐
成丽娜
钟水生
杨慧
潘梦秋
叶锦龙
王展航
KUANG Zuying;XIANG Jiao;ZHANG Xinfei;CHENG Li′ na;ZHONG Shuisheng;YANG Hui;PAN Mengqiu;YE Jinlong;WANG Zhanhang(Department of Neurology I,Guangdong 999 Brain Hospital,Guangzhou 510510,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第14期2311-2315,共5页
The Journal of Practical Medicine
基金
广东省医学科学技术研究基金项目(编号:B2016063)
