摘要
目的:探讨急性脑梗死溶栓术后脑灌注表现与临床预后的相关性。方法:选取2019年1-8月于本院行溶栓治疗的80例急性脑梗死患者,根据磁共振灌注(PWI)检查结果分为对照组(n=34,正常)与研究组(n=46,异常)。对照组单纯采用低分子肝素治疗,研究组采用尿激酶联合低分子肝素治疗。比较两组治疗前后相对达峰时间(rTTP)、相对脑血流平均通过时间(rMTT)、相对脑血容量(rCBV)、相对脑血流量(rCBF)、神经功能缺损及卒中后残疾情况。比较研究组治疗后不同美国国卫院脑卒中评估表(NIHSS)与Rankin修订量表(mRS)评分的rTTP、rMTT、rCBV、rCBF情况。分析治疗后脑灌注表现与临床预后的相关性。结果:治疗前,研究组rCBV、rCBF均低于对照组,而rMTT、rTTP均高于对照组(P<0.05);治疗后,两组rCBV、rCBF、rMTT、rTTP比较,差异均无统计学意义(P>0.05)。治疗前,研究组NIHSS与MRS评分均高于对照组(P<0.05);治疗后,两组NIHSS、MRS评分比较,差异均无统计学意义(P>0.05)。NIHSS与MRS评分越高,rCBV及rCBF越低,而rTTP与rMTT越高(P<0.05)。rCBV、rCBF与NIHSS、MRS评分均呈负相关(r=-0.245、-0.904,P<0.05),rTTP、rMTT与NIHSS评分、mRS评分均呈正相关(r=0.147、0.894,P<0.05)。结论:rCBV、rCBF与急性脑梗死预后呈正相关,rTTP、rMTT与急性脑梗死预后呈负相关,脑灌注表现可以为急性脑梗死溶栓术后患者预后判断提供科学的依据。
Objective:To explore the correlation between cerebral perfusion performance and clinical prognosis after thrombolysis in acute cerebral infarction.Method:A total of 80 patients with acute cerebral infarction underwent thrombolytic therapy in our hospital from January to August 2019 were selected.They were divided into control group (n=34,normal) and study group (n=46,abnormal) according to the results of magnetic resonance perfusion (PWI) examination.The control group was treated with Low Molecular Weight Heparin,and the study group was treated with Urokinase combined with Low Molecular Weight Heparin.The relative time to peak (rTTP),relative mean transit time (rMTT),relative cerebral blood volume (rCBV),relative cerebral blood flow (rCBF),neurological impairment and post-stroke disability were compared between the two groups before and after treatment.rTTP,rMTT,rCBV and rCBF of different national institutes of health stroke assessment scale (NIHSS) and Rankin modified scale (mRS) scores were compared in the study group after treatment.The correlation between cerebral perfusion performance and clinical prognosis after treatment were analyzed.Result:Before treatment,rCBV and rCBF in the study group were lower than those in the control group,while rMTT and rTTP were higher than those in the control group (P<0.05).After treatment,there were no significant differences in rCBV,rCBF,rMTT and rTTP between the two groups (P>0.05).Before treatment,NIHSS and mRS scores in the study group were higher than those in the control group (P<0.05).After treatment,there were no significant differences in NIHSS and mRS scores between the two groups (P>0.05).The higher the NIHSS and mRS scores,the lower the rCBV and rCBF,while the higher the rTTP and rMTT (P<0.05).rCBV and rCBF were negatively correlated with NIHSS and mRS (r=-0.245,-0.904,P<0.05).rTTP and rMTT were positively correlated with NIHSS score and mRS score (r=0.147,0.894,P<0.05).Conclusion:rCBV and rCBF are positively correlated with the prognosis of acute cerebral infarc
作者
单志斌
欧鸿儒
莫家彬
张冠业
简坚成
伍焕萍
SHAN Zhibin;OU Hongru;MO Jiabin;ZHANG Guanye;JIAN Jiancheng;WU Huanping(Affiliated Shunde Hospital of Ji’nan University,Foshan 528300,China)
出处
《中国医学创新》
CAS
2020年第8期119-123,共5页
Medical Innovation of China
基金
2019佛山市卫生和计划生育局项目(20190376)。
关键词
急性脑梗死
溶栓术
脑灌注
Acute cerebral infarction
Thrombolysis
Cerebral perfusion
