摘要
目的运用多模态CT脑成像技术来评估人尿激肽原酶(human urine kininogenase,HUK)对急性脑梗死患者的血流灌注及侧支循环,探讨其可能的作用机制。方法收集急性前循环脑梗死患者(acute anterior circulation cerebral infarction)75例,分为HUK治疗组和对照组(常规药物治疗),于治疗前、治疗第14天行两组患者的CT脑灌注成像(computer technology perfusion,CTP)和CT脑血管成像(computed tomographic angiography,CTA),观察两组CT脑灌注成像各参数(CBF、CBV、MTT、TTP)值及CTA侧枝血管的变化情况。结果(1)两组患者治疗后较治疗前CT脑灌注参数CBF、CBV均升高,参数MTT、TTP降低。HUK治疗组梗死区14 d后CBF升高较对照组明显(t=2.470,P<O.05);(2)HUK治疗组14 d后病灶侧MTT、TTP下降较对照组明显(t=2.126,t=2.213,P均<O.05);(3)HUK治疗组14 d后CTA最大密度投影(maximum intensity projection,MIP)动态观察侧支血管数量增多较对照组明显(χ^(2)=4.265,P<O.05);(4)HUK治疗组14 d后NIHSS评分改善较对照组明显(t=4.330,P<0.01)。结论HUK可有效改善急性脑梗死患者缺血组织的血流灌注,是一种治疗急性脑梗死有效的药物。
Objective To study the impact of human urinary kallidinogenase(HUK)on collateral circulation and blood perfusion in patients with acute cerebral ischemia(ACI)using multi-modality CT methods.Methods In a randomized controlled clinical trial,75 patients diagnosed with ACI were enrolled and divided into experiment group(treated with HUK)and control group(untreated with HUK).All participants underwent computer technology perfusion(CTP)and computed tomographic angiography(CTA)examination before and fourteenth day after treatment.The CT cerebral perfusion imaging(CTP),CT cerebrovascular imaging(CTA)and National Institutes of Health Stroke Scale(NIHSS)score were analyzed in two groups.The NIHSS score,cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTF),and time to peak(TTP)were compared between the two groups before and after 14 days therapy.Results①After treatment,The two group showed increased CBF and CBV values and decreased MTT and TTP values.The CBF improvement was significantly better in the HUK-treated group than in the control group(t=2.470,P〈0.05).②MTr and TIP were shorter in the HUK-treated group than in the control group(t=2.126,t=2.213,P〈0.05).③CTA maximum intensity projection(MIP)sequence revealed that the number of patients collateral vessels was significantly increased in the HUK-treated group than in the control group(χ^(2)=4.265,P〈0.05).④The NIHSS score improvement was significantly better in the HUK-treated group after 14 days treatment than in the control group(t=4.330,P〈0.05).Conclusion Human urinary kallidinogenase can improve blood peffusion and ameliorates neurological deficits.It is a safe and effective drug for treating ACI patients.The muhi-modality CT methods are effective measure to assess blood perfusion and collateral circulation in patients with acute cerebral ischemia.
作者
汪进丁
万姗姗
刘芳琼
杨春静
徐丽君
万和斌
刘刚
无
WANG Jinding;WAN Shanshan;LIU Fangqiong;YANG Chunjing;XU Lijun;WAN Hebin;LIU Gang(Department of Neurology,First people's Hospital of Jiujiangcity,Jiujiang 332000,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2017年第10期597-602,共6页
Chinese Journal of Nervous and Mental Diseases
基金
江西省科技厅2015年科技计划(编号:20151BBG70150)
