半定量分析法肺通气灌注扫描对急性肺栓塞溶栓的疗效评价

Efficacy Evaluation of Tthrombolysis with Lung Perfusion Imaging

目的:评价肺通气/灌注显像监测肺栓塞患者溶栓治疗疗效的价值。方法:70例确诊为急性肺栓塞的患者,男44例,女26例,平均年龄(51.4±13.8)岁[(24～78)岁]。将全部病例按照病程长短分为3组:第1组为病程1周以内,共27例;第2组为病程在(1～2)周,共20例;第3组为病程≥2周,共23例。所有患者均于治疗前及溶栓后4 d、30天行肺灌注显像,采集条件一致。结果:各组患者溶栓治疗后复查,4天和30天时的缺损百分比与治疗前比较均有显著性差异;病程为一周以内的患者和病程在(1～2)周的患者溶栓后4天、30天的疗效对比无显著性差异,而两者与病程为>2周的患者溶栓后4天、30天的疗效比较均有显著性差异。结论:肺通气/灌注显像在肺栓塞患者疗效评价中有重要价值;溶栓治疗是急性肺栓塞有效的治疗方法;以病程2周为时间窗,溶栓疗效显著,病程在2周以上的肺栓塞患者有一定疗效,应对急性肺栓塞患者行及早的溶栓治疗。

Objective： To investigate the role of lung perfusion imaging in evaluating thrombolysis therapyin patients with pulmonary embolism. Methods：70 patients （ Males ： Female = 44 ： 26） aged （24-78） years（mean 51.4. years）, were classified into 3 groups according to their courses of the disease： Group 1： less than lweek （n=27）; Group 2： between 1 to 2 weeks （n=20）;Group 3： longer than 2 weeks （n=23）. Lung perfusionimaging was performed on all cases before thrombolysis, 4 days after thrombolysis and one month after continuous anticoagulative therapy.Results：Percentage of perfusion defect store has significant differences betweenthrombolysis therapy here is no diffentent of efficacy evaluation of thrombolysi between Group 1 and Group 2 ,but the differences between. Group 3 and Group 1, 2 were significant （P〈0.001）. It was further improved in 87.5% in patients given long-term anticoagulative therapy. Conclusion： Lung perfusion imaging is valuable for efficacy evaluation of thrombolysis. As to patients with the disease course less than 2 weeks, Thrombolysis eombinedwith anticoagu-lative therapy are effective to some extent for pulmonary embolismwith the course more than 2 week., and the patients should be actively treated so as to improve the prognosis for more patients with pulmonary embolism.