肺灌注显像UPET评分在肺栓塞疗效评价中的应用

UPET method of pulmonary perfusion imaging in evaluation of the therapeutic effect of pulmonary embolism

目的探讨肺灌注显像UPET评分在肺栓塞患者肺血流灌注改善情况及疗效评价中的临床价值。方法接受抗凝或溶栓治疗的28例PE患者均在治疗前完成肺灌注/通气显像,治疗后2周内复查肺灌注显像,由2名核医学专业医师对图像进行定性分析,然后对治疗前后灌注图像进行UPET评分半定量分析。结果 28例PE患者经临床治疗后,其中13例治疗后局部血流灌注有明显改善,8例轻度改善,5例未见有变化,2例恶化。其中21例血流灌注有改善的患者治疗前评分为0.55±0.12,治疗后为0.32±0.09,治疗前后分值的变化有统计学意义(P<0.05);7例无改善患者治疗前为0.25±0.11,治疗后为0.23±0.12,治疗前后分值的变化无统计学意义(P>0.05)。两组间改善率比较有统计学意义(P<0.05)。结论 UPET评分可评价PE患者治疗前后肺血流灌注改善情况,并对其疗效评价具有一定的临床价值。

Objective To assess the clinical value of urokinase pulmonary embolism trial（UPET） method of pulmonary perfusion imaging in evaluation of the improvement of pulmonary perfusion and therapeutic effect of pulmonary embolism. Methods Twenty-eight patients diagnosed as pulmonary embolism received anticoagulant or thrombolytic therapy.The pulmonary ventilation/perfusion imaging was performed in all patients before treatment,and the pulmonary perfusion imaging was reexamined in 2 weeks after treatment. UPET method of semi-quantitative visual evaluation was used to analyze to the perfusion imaging. Results Of 28 patients,13 patients were obviously improved after therapy,8 patients were lightly improved,5 patients had no change,and 2 patients had aggravation.The score had a significant change in 21 patients with improved pulmonary perfusion before and after treatment（0.55±0.12 vs 0.32±0.09,P0.05） ,but the score showed no significant change in the other 7 patients before and after treatment（P0.05） .The improvement rate was significantly different between patients with and without improved pulmonary perfusion（P0.05） . Conclusion The UPET method could effectively evaluate the improvement of pulmonary perfusion after treatment,and it can be used to evaluate the therapeutic effect of pulmonary embolism in the clinical application.