Parker J A, Drum D E, Feldstein M L, Goldhaber S Z
Department of Radiology, Beth Israel Hospital, MA 02215.
J Nucl Med. 1995 Mar;36(3):364-8.
Data from three trials of thrombolytic therapy for pulmonary embolism (PE) were combined to assess the utility of perfusion lung scan defect scoring in predicting the response to thrombolytic therapy.
Pre- and post-therapy lung scans and duration of symptoms were available for a total of 221 patients, 167 were treated with various thrombolytic regimes and 54 were treated with heparin alone.
Improvement in the lung scan defect score was correlated with larger initial defect score (r = 0.53), segmental appearance (r = 0.31) and shorter duration of symptoms (r = 0.20). There was no significant residual correlation between improvement and segmental appearance in a multiple regression analysis after accounting for initial defect score and duration of symptoms. Two lung scan scoring methods (segmental and anterior-posterior method) provided similar results with low interobserver variability (r = 0.90 for both methods).
This study indicates that the baseline perfusion lung scan defect severity helps to predict the response to thrombolytic therapy.
合并三项肺栓塞（PE）溶栓治疗试验的数据，以评估灌注肺扫描缺损评分在预测溶栓治疗反应中的效用。
共有221例患者可获得治疗前和治疗后的肺扫描及症状持续时间，其中167例接受了各种溶栓方案治疗，54例仅接受肝素治疗。
肺扫描缺损评分的改善与初始缺损评分较高（r = 0.53）、节段性表现（r = 0.31）和症状持续时间较短（r = 0.20）相关。在考虑初始缺损评分和症状持续时间的多元回归分析中，改善与节段性表现之间无显著残余相关性。两种肺扫描评分方法（节段性和前后位法）提供了相似的结果，观察者间变异性较低（两种方法r均 = 0.90）。
本研究表明，基线灌注肺扫描缺损严重程度有助于预测溶栓治疗的反应。
