CAJ | 학술논문

目的比较静脉溶栓、静脉溶栓+延迟冠状动脉内支架置入术（溶栓+延迟支架）治疗急性脑梗死的效果。方法 45例急性脑梗死患者分为溶栓组23例和溶栓+延迟支架组22例，溶栓组于溶栓后3周、溶栓+延迟支架组于支架术后1周（全部病例均于入院后3周）行99mTc2ECD脑灌注显像(SPECT)，用半定量法对其脑摄取99mTc2ECD的程度进行打分，并计算每个患者脑灌注显像的总积分。结果溶栓组、溶栓+延迟支架组脑灌注显像的总积分分别为(12.4±4.6)、(9.7±3.8)分，两组差异有统计学意义(t =2.73，P＜0.01)。结论在急性脑梗死的治疗中，溶栓+延迟支架疗效明显优于单纯溶栓治疗，99mTc2MIBI脑灌注SPECT显像可作为判断溶栓、溶栓+延迟支架治疗急性脑梗死疗效比较客观的指标。
목적 비교정맥용전、정맥용전+연지관상동맥내지가치입술（용전+연지지가）치료급성뇌경사적효과。방법 45례급성뇌경사환자분위용전조23례화용전+연지지가조22례，용전조우용전후3주、용전+연지지가조우지가술후1주（전부병례균우입원후3주）행99mTc2ECD뇌관주현상(SPECT)，용반정량법대기뇌섭취99mTc2ECD적정도진행타분，병계산매개환자뇌관주현상적총적분。결과 용전조、용전+연지지가조뇌관주현상적총적분분별위(12.4±4.6)、(9.7±3.8)분，량조차이유통계학의의(t =2.73，P＜0.01)。결론 재급성뇌경사적치료중，용전+연지지가료효명현우우단순용전치료，99mTc2MIBI뇌관주SPECT현상가작위판단용전、용전+연지지가치료급성뇌경사료효비교객관적지표。
Objective To evaluate and compare the therapeutic effect among intravenous rt2PA thrombolysis,thrombolysis plus delayed intracoronary stenting for acute ischemic stroke onset using 99mTc2ECD SPECT imaging.Methods 45 cases of acute ischemic stroke onset were divided into two groups which were the thrombolysis group( n = 23 ) ,thrombolysis plus delayed stenting group (n = 22), 99mTc2MIBI SPECT imaging was performed 3 weeks after thrombolysis therapy or 1 week after intracoronary stenting. The score of 99mTc2MIBI brain uptake were analyzed semiquantitatively and the total score of myocardial 99mTc2ECD uptake was calculated. Results The scores of the 2 groups were( 12. 4 ± 4. 6) and( 9. 7 ± 3. 8 ) respectively, Significant difference was shown in the thrombolysis plus delayed stenting group compared with the thrombolysis group (P ＜ 0. 01 ). Conclusion 99mTc2ECD SPECT imaging had been proved to be an objective parameter for evaluating the therapeutic effect of the various treatments of AMI. Thrombolysis plus delayed stenting was more effective than thrombolysis.