CAJ | 학술논문

目的：通过肺栓塞(PE)动物模型的建立，评价肺灌注显像对肺栓塞诊断及疗效观察中的价值。方法：计算机随机编号，取中国实验用小型猪8头，平均体重16.1±1.4 kg；建立模型前均行肺灌注显像及选择性肺动脉造影(CPA)，取自体猪血2～5 ml制血栓，通过右心导管将栓子加压注入肺动脉；建立PE模型。建立模型后及溶栓治疗后均行肺灌注显像及CPA，前后采集条件一致。结果：8头猪造模前CPA均正常，肺灌注显像1例左肺放射性分布不均，肺灌注显像特异性87.5%(1/8)。7例存活的模型猪，5例造模成功，2例不明显；以单侧肺观察，肺灌注显像与肺动脉造影对比，肺灌注显像诊断PE灵敏度100%，准确率90%。1例肺动脉造影正常，肺灌注显像为亚肺段栓塞，与尸检肉眼病理所见一致，溶栓后恢复正常血流灌注；如果以溶栓治疗有效为标准则准确率增至100%。溶栓疗效观察肺灌注显像与肺动脉造影二者结果一致。1例CPA溶通，肺灌注显像部分改善，尸检证实为部分坏死、实变。结论：肺灌注显像诊断PE具有很高的敏感性和特异性，与肉眼病理所见完全吻合。可作为肺动脉造影前的筛选，及临床疗效观察的重要手段。
목적：통과폐전새(PE)동물모형적건립，평개폐관주현상대폐전새진단급료효관찰중적개치。방법：계산궤수궤편호，취중국실험용소형저8두，평균체중16.1±1.4 kg；건립모형전균행폐관주현상급선택성폐동맥조영(CPA)，취자체저혈2～5 ml제혈전，통과우심도관장전자가압주입폐동맥；건립PE모형。건립모형후급용전치료후균행폐관주현상급CPA，전후채집조건일치。결과：8두저조모전CPA균정상，폐관주현상1례좌폐방사성분포불균，폐관주현상특이성87.5%(1/8)。7례존활적모형저，5례조모성공，2례불명현；이단측폐관찰，폐관주현상여폐동맥조영대비，폐관주현상진단PE령민도100%，준학솔90%。1례폐동맥조영정상，폐관주현상위아폐단전새，여시검육안병리소견일치，용전후회복정상혈류관주；여과이용전치료유효위표준칙준학솔증지100%。용전료효관찰폐관주현상여폐동맥조영이자결과일치。1례CPA용통，폐관주현상부분개선，시검증실위부분배사、실변。결론：폐관주현상진단PE구유흔고적민감성화특이성，여육안병리소견완전문합。가작위폐동맥조영전적사선，급림상료효관찰적중요수단。
Objective:The study is to evaluate the use of perfusion scan in the diagnosis and therapy in animal model of pulmonary embolism.Method:8 male computer-randomised Chinese experimental pigs,with average weight 16.1±1.4 kg. 2～5 ml blood was to made emboli,and was sent to pulmonary artery by catheter to create pulmonary embolism animal model.Both chosen pulmonary angiography and nuclear perfusion scan were performed before and after creating animal model as well as thrombolytic therapy,and then two methods were compared.Result:CPA were all normal,and one didn't show well-distribution in left lung,and specificity of pulmonary perfusion scan was 87.5%(1/8).CPA showed that 5 pigs were formed into PE in 7 living pigs,and the other 2 were not clear.Compared with CPA,the sensitivity and accuracy of pulmonary perfusion scan were 100% and 90% respectively,consent with pathological autopsy.One was normal in pulmonary angiography and perfusion scan was sub-segmental embolism,and after thrombolytic therapy,pulmonary perfusion returned to normal.If the standard was that thrombolytic therapy and pulmonary angiogram was effective,the accuracy was raised to 100%,perfusion scan completely accorded with pulmonary angiogram.One CPA showed completely open,and perfusion scan partly amlieration,autopsy showed necrosis.Conclusion:The sensitivity and specificity of perfusion scan was high in diagnosing pulmonary embolism,and completely consent with pathological autopsy.Perfusion scan could be the screen before pulmonary angiogram,and the important tool to observe therapy effect.