^(99)Tc^m-MIBI对判断冠心病患者PTCA术后疗效的价值

Value of ^(99)Tc^m-MIBI for judging postoperative effects of PTCA treatment on patients with CAD

目的探讨99Tcm MIBI对判断经皮冠状动脉腔内成形术(PTCA)及支架置入术后的疗效及测定再狭窄以及估测预后的临床价值。方法对31例确诊冠状动脉性心脏病(CAD)患者PTCA及支架置入术前、术后行99Tcm MIBI静息门控断层心肌灌注显像(GSPECT)进行研究。患者均于PTCA前和PTCA后1个月行GSPECT,其中21例于PTCA后3个月再行GSPECT。经SPECT计算机处理获得舒张末期容积(EDV)、收缩末期容积(ESV)、左室射血分数(LVEF)等心功能参数。结果①PTCA术后1个月有48.1%的异常节段血流灌注较前改善,术前后的心功能参数均无显著差异(P>0.05)。②PTCA后3个月行静息GSPECT,再狭窄率14.3%(3/21)。结论静息99Tcm MIBIGSPECT可以较好的评价PTCA术的疗效,并可判定PTCA术后冠脉是否发生再狭窄。

Objective To evaluate the postoperative effect of ~99 Tcm-MIBI after percutaneous transluminal coronary angioplasty(PTCA) and to detect the restenosis after PTCA. Methods ~99 Tcm-MIBI myocardial perfusion imaging was used before and after 1 month(n=31) and 3 months(n=21) following PTCA. All the patients received PTCA and/or stent treatment in 2 weeks after the first gated cardiac SPECT (GSPECT). GSPECT allowed to obtain LV perfusion and function parameters including end diastolic volume(EDV), end systolic volume (ESV) and ejection fraction(EF). Results The abnormal myocardial segment 48.1% was improved respectively after 1 month of PTCA. There was no significant difference in myocardial function parameters before and after PTCA. Twenty one patients underwent the 3 rd myocardial perfusion imaging in 3 months after PTCA. The rate of restenosis was 14.3%(3/21). Conclusion The rest GSPECT myocardial perfusion imaging with MIBI can be used to evaluate the effectiveness of PTCA and to detect the coronary artery restenosis after PTCA.