CT灌注原始图像联合依达拉奉在脑卒中患者中的应用效果

Application of CT perfusion original image combined with edaravone in stroke patients

  • 摘要:
      目的  探讨CT灌注原始图像联合依达拉奉在脑卒中患者诊疗中的应用效果及对血液流变学的影响。
      方法  选择治疗脑卒中患者90例作为对象,所有患者经血管造影检查确诊。手术前所有患者行CT灌注原始图像诊断,记录患侧部位局部脑血流(CBF)、局部脑血容量(CBV)及平均通过时间(MTT)指标(以健侧作为对照)。将入组患者分为对照组(n=45)与观察组(n=45)。对照组给予重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗,观察组联合依达拉奉治疗,治疗14 d后对患者效果进行评估,同时比较2组诊断效果、神经功能及血液流变学水平。
      结果  90例脑卒中患者经CT灌注原始图像确诊87例,血管造影检查符合率为96.67%, 差异无统计学意义(P>0.05); 患侧CBF水平低于健侧(P < 0.05); 患侧MTT水平高于健侧(P < 0.05); 观察组治疗后14 d美国国立卫生研究院卒中量表(NIHSS)评分低于对照组,日常生活活动(ADL)评分高于对照组(P < 0.05); 观察组治疗后14 d纤维蛋白原、红细胞压积、全血高切黏度、血浆黏度及全血低切黏度水平均低于对照组(P < 0.05)。
      结论  将CT灌注原始图像用于脑卒中患者中能获得较高的诊断准确率,给予患者依达拉奉治疗能改善患者神经功能及血液流变学水平。

     

    Abstract:
      Objective  To investigate the effect of CT perfusion original image combined with edaravone on the diagnosis and treatment of stroke patients and its influence on hemorheology.
      Methods  Ninety patients with stroke were enrolled, and were diagnosed by angiography. All patients underwent CT perfusion original image diagnosis before operation. Regional cerebral blood flow (CBF), regional cerebral blood volume (CBV) and mean transit time (MTT) indicators (healthy side as control group)were recorded. The enrolled patients were divided into control group (n=45) and observation group (n=45). The control group was treated with thrombolytic therapy of recombinant tissue plasminogen activator(rt-PA), while the observation group was additionally given edaravone. The clinical effect was evaluated after 14 days of treatment. The diagnostic effects, neurological function and hemorheology of the two groups were compared.
      Results  Of the 90 stroke patients, 87 were diagnosed by CT perfusion original image, with the coincidence rate of 96.67% (P>0.05). The CBF level of the affected side was lower, and MTT level of the affected side was higher than that of healthy side (P < 0.05). The score of National Institutes of Health Stroke Scale(NIHSS)was lower in the observation group, and Activities of Daily Living (ADL) score of the observation group was higher than that of the control group (P < 0.05). Fibrinogen, hematocrit, whole blood high-viscosity, plasma viscosity and whole blood low-cut viscosity at 14 d after treatment in the observation group were lower than that in the control group (P < 0.05).
      Conclusion  The CT perfusion original image can be used to obtain high diagnostic accuracy in patients with stroke. Administration of edaravone can improve neurological function and hemorheology.

     

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