CT灌注成像指导下超时间窗缺血性卒中患者静脉溶栓研究

发布时间：2019-03-13 21:44

【摘要】：目的探讨CT灌注成像(CTP)对超时间窗急性缺血性卒中患者静脉溶栓进行指导的可行性。方法按照发病时间及CTP检查是否存在缺血半暗带(IP)将35例患者分为三组:4.5 h组、4.5 h且存在IP组及4.5 h无IP组。前二组均进行静脉溶栓,第三组采用常规治疗,并于24 h、7 d、30 d及90 d分别进行神经功能评分。结果前二组治疗后神经功能明显改善(P0.01),且两组之间差异无统计学意义(P0.05);常规治疗组24 h NIHSS评分无统计学意义(P0.05),30 d改良Rankin评分无统计学差异(P0.05),90 d有明显差异(P0.01);常规治疗组与溶栓组相比24 h、7 d、30 d神经功能评分统计学差异不明显(P0.05),90 d神经功能评分前者明显低于后者(P0.01)。结论使用CTP指导急性缺血性卒中超时间窗患者静脉溶栓有重要意义。
[Abstract]:Objective to investigate the feasibility of CT perfusion imaging (CTP) in the guidance of intravenous thrombolysis in patients with acute ischemic stroke with super-time window. Methods 35 patients with ischemic penumbra (IP) were divided into three groups according to the onset time and CTP examination: 4.5h group, 4.5h group and IP group and 4.5h group without IP. The first two groups were treated with intravenous thrombolysis, and the third group were treated with routine therapy, and the neurological function scores were evaluated at 24 h, 7 d, 30 d and 90 d, respectively. Results the neurological function of the first two groups was significantly improved after treatment (P0.01), and there was no significant difference between the two groups (P0.05). There was no significant difference in 24-hour NIHSS score in the routine treatment group (P0.05), and there was no significant difference in the modified Rankin score on the 30th day (P0.05), and there was a significant difference on the 90th day (P0.01). Compared with thrombolysis group, there was no significant difference in neurological function scores at 24 hours, 7 days and 30 days in the routine treatment group (P0.05), while the neurological function scores in the former group were significantly lower than those in the latter group on the 90th day (P0.01). Conclusion it is important to use CTP to direct intravenous thrombolysis in patients with acute ischemic stroke with super-time window.
【作者单位】：江苏省张家港市中医医院放射科;江苏省张家港市中医医院神经内科;
【基金】：江苏省张家港市科技支撑计划(社会发展)项目(编号:ZKS1216)
【分类号】：R743.3;R816.1

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