本文選題：高血壓 + 肺　； 參考：《中國醫(yī)學(xué)影像技術(shù)》2017年08期

【摘要】：目的采用~(99)Tc~m-人體大顆粒聚合白蛋白(~(99)Tc~m-MAA)肺灌注斷層顯像評價肺動脈血栓內(nèi)膜剝脫術(shù)(PTE)對慢性血栓栓塞性肺動脈高壓(CTEPH)的療效。方法對16例CTEPH患者分別于術(shù)前、術(shù)后6~12個月行肺灌注斷層顯像,觀察術(shù)前、術(shù)后肺葉、肺段灌注病變及改善情況,計算全肺灌注缺損百分比(PPDs%),并采用超聲心動圖觀察術(shù)前、術(shù)后肺動脈收縮壓(SPAP)的變化。結(jié)果 16例患者術(shù)后SPAP[(36.56±8.47)mmHg]較術(shù)前[(90.52±14.55)mm-Hg]明顯減低(t=14.14,P0.001)。PTE術(shù)前16例患者的96個肺葉中有86個(86/96,89.58%)存在灌注異常,術(shù)后完全改善、部分改善的肺葉分別為21個(21/86,24.42%)、65個(65/86,75.58%);術(shù)前16例患者的304個肺段中,230個(230/304,75.66%)肺段灌注異常,術(shù)后完全改善、部分改善和未改善的肺段分別為73個(73/230,31.74%)、74個(74/230,32.17%)和83個(83/230,36.09%)。術(shù)前PPDs%為(56.79±14.54)%,術(shù)后6~12個月降低為(28.20±15.24)%(t=8.13,P0.001)。PPDs%與同期SPAP呈正相關(guān)(r=0.68,P0.001)。結(jié)論 PTE可使CTEPH患者的SPAP明顯降低,肺血流灌注明顯改善,肺灌注顯像可有效評價PTE療效。
[Abstract]:Objective to evaluate the efficacy of pulmonary perfusion tomography (PTET) in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) by using the lung perfusion tomography (SPECT). Methods Pulmonary perfusion tomography was performed in 16 patients with CTEPH before operation and 6 ~ 12 months after operation. The pulmonary lobes and lung segment perfusion lesions were observed before and after operation. The percentage of total pulmonary perfusion defect was calculated and the preoperative echocardiography was used to observe the preoperation. Changes of pulmonary systolic blood pressure (spp) after operation. Results SPAP [36.56 鹵8.47)mmHg] in 16 patients after operation was significantly lower than that before operation [90.52 鹵14.55)mm-Hg]. 86 of 96 pulmonary lobes (86 / 96, 89.58) had abnormal perfusion, and there was complete improvement after operation. The partially improved lobes were 21 / 21 / 86 / 24.42, 65 / 65 / 86 / 86 / 75.58; of the 304 lung segments of 16 patients before operation, 230 / 230 / 304 / 75.66 had abnormal perfusion and completely improved after operation. The partial and unimproved lung segments were 73 / 23 / 230 / 31.74, 74 / 74 / 73032.17) and 83 / 833 / 30 / 36.09, respectively. Preoperative PPDs% was 56.79 鹵14.54m and decreased to 28.20 鹵15.24m per month after the operation. There was a positive correlation between PPDs% and SPAP in the same period. Conclusion PTE can significantly reduce SPAP and improve pulmonary perfusion in patients with CTEPH. Pulmonary perfusion imaging can effectively evaluate the efficacy of PTE.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院核醫(yī)學(xué)科;
【分類號】：R544.1;R817.4

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