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目的探讨低剂量CT灌注成像在急性脑梗死治疗中的应用价值。方法选择2012年1月-2014年12月赵县人民医院收治的急性脑梗死患者100例,均为发病内6h,并进行溶栓治疗,治疗前后行低剂量CT灌注成像检查,观察溶栓治疗前后病变区相对脑血流量(r CBF)、相对脑血容量(r CBV)、相对平均通过时间(r MTT),溶栓治疗前后进行神经功能缺损评分(NIHSS评分)。结果急性脑梗死发病6h内CT灌注成像均显示灌注异常的缺血半暗带,表现为r CBF、r CBV降低,r MTT延迟,表明存在缺血半暗带。溶栓后大部分患者脑灌注情况明显改善,与溶栓前比较梗死核心区r CBF、r CBV及缺血半暗带区r CBV值差异无统计学意义(P>0.05)。患者缺血半暗区r CBF显著增加,r MTT减小,溶栓后患者NIHSS评分显著降低,差异均有统计学意义(P<0.05)。结论急性脑梗死患者超早期行低剂量CT脑灌注成像能显示缺血半暗带,溶栓治疗后缺血半暗区灌注异常明显改善,神经功能缺损情况改善,对急性脑梗死静脉溶栓治疗具有临床指导意义。
Objective To investigate the value of low-dose CT perfusion imaging in the treatment of acute cerebral infarction. Methods One hundred patients with acute cerebral infarction who were treated in Zhaoxian People’s Hospital from January 2012 to December 2014 were all included within 6 hours after onset of thrombolytic therapy. Low-dose CT perfusion imaging was performed before and after treatment. Thrombolytic therapy The rCBF, r CBV, r MTT and NHSS before and after the thrombolysis were measured before and after the lesion. Results CT perfusion imaging within 6 hours after onset of acute cerebral infarction showed perfusion-like ischemic penumbra with r CBF, r CBV reduction and r MTT delay, indicating the presence of ischemic penumbra. Cerebral perfusion in most patients after thrombolysis was significantly improved. There was no significant difference in r CBF, r CBV and r CBV between ischemic penumbra and infarct core area before thrombolysis (P> 0.05). Patients with ischemic penumbra r CBF increased significantly, r MTT decreased thrombolytic patients NIHSS score was significantly lower, the difference was statistically significant (P <0.05). Conclusion Ultrathin cerebral infarction patients underwent low-dose CT perfusion imaging can show ischemic penumbra, thrombolysis after ischemic perfusion improved significantly improved abnormalities, neurological deficits improved, intravenous thrombolytic therapy of acute cerebral infarction With clinical guidance.