关键词: 脑梗死; 体层摄影术; X线计算机; 脑缺血; 血栓溶解疗法

Abstract: Objective To investigate the changes of computed tomography perfusion imaging(CTPI) inpatients with hyperacute cerebral infarction before and after thrombolytic therapy.Methods Forty-five patients with acute cerebral infarction within 6 hours after onset wererandomly divided into thrombolytic group and control group. CTPI was performed on all patientsbefore and after thrombolytic therapy in thrombolytic group, and to observe the changes ofrelative cerebral blood flow(rCBF), relative cerebral blood volume(rCBV) and relative meantransit time(rMTT) on ischemic area, and to evaluate the changes of neurological function deficitscale before and after thrombolytic therapy . Compared these results between thrombolytic groupand control group.Results Abnormal perfusion changes corresponding to clinical symptoms were all found intwo groups, including CBF and CBV decreased, MTT delayed, which indicate there was anischemic penumbra. Follow-up CTPI showed that the cerebral perfusion improved in most casesof thrombolytic group, there was no significant difference of rCBF and rCBV on infarction corecompared to that before thrombolytic(P >0.05), the rCBF was significantly increased(P <0.01)andrMTT was significantly decreased(P <0.01)on ischemic penumbra after thrombolytic therapy. TherCBF and rCBV were significantly decreased and rMTT was significantly increased on ischemicpenumbra in control group after routine therapy(P <0.01). After therapy, the rCBF and rCBVof ischemic penumbra were significantly increased and rMTT was significantly decreased in thrombolytic group than that in the control group(P <0.01). Improvement of national institutes ofhealth stroke scale(NIHSS)in thrombolytic group was higher than that in control group.Conclusion The rCBF is increased and rMTT is decreased in patients with hyperacute cerebralinfarction after thrombolytic therapy, and the NIHSS is decreaed.

Key words: Brain infarction; Tomography X-ray computed; Brain ischemia; Thrombolytictherapy