延迟的心肌灌注改善现象──PTCA后潘生丁核素心肌灌注随访研究

Delayed Sequential Improvement of Myocardial Perfusion After Dipyridamole Administration Being Confirmed by ^(99m)Tc-MIBI Myocardial Perfusion Scintigraphy and Followed by Successful Percutaneous Transluminal Coronary Artery Angioplasty(PTCA)

为研究成功的经皮冠状动脉腔内成形术（PTCA）后心肌灌注变化情况，对24例非心肌梗塞患者分别于PTCA前，PTCA后1个月及12个月内进行了潘生丁核素心肌灌注显像检查。共分析49个缺血节段，结果20例心肌灌注显像异常（40个节段）在1个月内完全恢复正常，4例在此时间内心肌灌注（9个节段）未能完全恢复正常，而在其后的随访中完全恢复正常（2例），呈现“延迟”的心肌灌注改善现象。表明PTCA后较短时间内异常的负荷心肌灌注显像并不总表示残余冠状动脉狭窄或早期再狭窄。

To study myocardial perfusion changes after successful PTCA, 24 patients without myocardial infarction taking dipyridamole underwent 99m Tc-MIBI myocardial perfusion tomography before and at 1、 6 and 12months after PTCA. 49 ischemic segments were analysed. after PTCA, 40 ischemic segments (20 patients) became normal and 9 segments (4 patients) improved but did not return to normal within one month, and remainedthe same in the repeat tests at six month, At near 12 month follow up, myocardial perfusion of two patients became normal, showing 'delayed' improvement. We concluded that an abnormal stress myocardial perfusion studyrecorded relatively short term after PTCA did not necessarily reflect the residual coronary artery stenosis or recurrence of coronary disease.