摘要
对２６例肝硬化、５例非肝硬化性肝胆疾病和１０例非肝胆疾病（对照组）患者，采用^（９９ｍ）ＴｃＭＩＢＩ直肠给药，测定心／肝核素显像比值（Ｈ／Ｌ比值）。对照组在给药后肝脏迅速清晰地显像，而心影较弱，其Ｈ／Ｌ比值为０．１４１±０．０４９。肝硬化门体分流组，肝影较弱而心影明显，其Ｈ／Ｌ比值明显高于对照组。Ｈ／Ｌ比值与肝功能Ｃｈｉｌｄ－Ｐｕｇｈ分级有明显的相关性。同时对５例肝硬化伴食管静脉曲张出血后患者服用心得安前后监测Ｈ／Ｌ比值，发现患者在服用心得安后Ｈ／Ｌ比值较服药前降低（Ｐ＜０．０５）。^（９９ｍ）Ｔｃ－ＭＩＢＩ经直肠给药门静脉显像可作为无创伤性监测肝硬化门体分流及药物治疗反应的方法。
The purpose of this study is to evaluate portal-systemic circulation with administration of 99mTc-MIBI per rectum in 26 patients with liver cirrhosis,5 patients with non-cirrhotic hepatobiliary diseases and 10 normal controls.In normal controls,the liver was clearly and quickly visualized,whereas the images of the heart was very poor,the H/L ratio was 0.141±0.049.In the patients of liver cirrhosis associated with portal-systemic shunts,the liver was less clearly visualized,whereas radioactivity in the heart became more evident.The H/L ratio of radioisotopic imaging was markedly higher in the group of liver cirrhosis than the other grotips.There was a trend correlation between H/L ratio and Child-Pugh classification.The effect of propranolol on portal circulation in 5 patients with portal-systemic shunts of liver cirrhosis was studied by 99mTc-MIBI per rectum imaging.Preliminary results showed that propranolol can significantly reduce the H/L ratio.The present data suggests that the 99mTc-MIBI per rectum imaging seemed to be a noninvasive method,very useful in evaluating portal-systemic shunts with liver cirrhosis.
