溶栓及延迟支架置入治疗急性脑梗死脑灌注显像的研究  

A comparative study of intravenous thrombolysis and late intracoronary stenting in treatment of acute ischemic stroke onset using 99mTc2ECD SPECT imaging

作　　者：解小芬[1] 于扬洁[1] 郭喆[1] 

机构地区：[1]北京军区总医院核医学科,北京市100700

出　　处：《中国基层医药》2011年第17期2329-2330,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的比较静脉溶栓、静脉溶栓＋延迟冠状动脉内支架置入术（溶栓＋延迟支架）治疗急性脑梗死的效果。方法45例急性脑梗死患者分为溶栓组23例和溶栓＋延迟支架组22例，溶栓组于溶栓后3周、溶栓＋延迟支架组于支架术后1周（全部病例均于入院后3周）行99mTc2ECD脑灌注显像（SPECT），用半定量法对其脑摄取99mTc2ECD的程度进行打分，并计算每个患者脑灌注显像的总积分。结果溶栓组、溶栓＋延迟支架组脑灌注显像的总积分分别为（12．4±4．6）、（9．7±3．8）分，两组差异有统计学意义（t=2．73，P〈0．01）。结论在急性脑梗死的治疗中，溶栓＋延迟支架疗效明显优于单纯溶栓治疗，99mTc2MIBI脑灌注SPECT显像可作为判断溶栓、溶栓＋延迟支架治疗急性脑梗死疗效比较客观的指标。Objective To evaluate and compare the therapeutic effect among intravenous rt2PA thrombolysis,thrombolysis plus delayed intracoronary stenting for acute ischemic stroke onset using 99mTc2ECD SPECT imaging. Methods 45 cases of acute ischemic stroke onset were divided into two groups which were the thrombolysis group（ n = 23） ,thrombolysis plus delayed stenting group （n = 22）,99mTc2MIBI SPECT imaging was performed 3 weeks after thrombolysis therapy or 1 week after intraeoronary stenting. The score of 99mTc2MIBI brain uptake were analyzed semiquantitatively and the total score of myocardial 99mTc2ECD uptake was calculated. Results The scores of the 2 groups were（ 12. 4 ± 4. 6） and（ 9. 7 ± 3.8 ） respectively, Significant difference was shown in the thrombolysis plus delayed stenting group compared with the thrombolysis group（P 〈0. 01 ）. Conclusion 99mTcECD SPECT imaging had been proved to be an objective parameter for evaluating the therapeutic effect of the various treat- ments of AMI. Thrombolysis plus delayed stenting was more effective than thrombolysis.

关 键 词：放射性核素显像 脑梗死 支架 

分 类 号：R74[医药卫生—神经病学与精神病学]