硝酸甘油介入^(99m)Tc-MIBI+门控心肌断层显像在心肌干细胞移植中的临床应用研究

Nitroglycerin ^(99m)Tc-sestaMIBI Gated Myocardial Tomography Imaging to Evaluate Curative Effect of Peripheral Blood Stem Cell Transplantation

【目的】探讨硝酸甘油(NG)介入99mTc-MIBI+门控心肌活力显像在冠心病心梗后病变区心肌细胞是否成活及梗塞灶在干细胞移植治疗后的疗效。【方法】对16例冠心病移植前和移植后的心肌活力+门控心肌断层显像,对心肌灌注活力评分,左室射血分数、移植前移植后心肌梗死区摄取比值测定、心肌灌注缺损指数的观测比较。【结果】干细胞移植后心肌灌注活力评分从57.1%增加到84.2%,左室射血分数从42.1±3.6增加到50.2±2.7、移植前移植后心肌梗死区摄取比值测定22.4±7.3增加到39.7±9.7、心肌灌注缺损指数10.9±2.3减少到8.0±2.5。【结论】心肌活力+门控心肌断层显像,对临床决策冠心病心肌梗死后是否进行干细胞移植和移植后是否成功提供了较有价值的手段和客观依据。

To investigate the value of nitroglycerin 99mTc-sestaMIBI gated myocardial tomography imaging in evaluating myocardial viability and dysfunctional segments after acute myocardial infarction （MI） and curative effect of peripheral blood stem cell transplantation. [Methods]16 patients with MI underwent nitroglycerin 99mTc-sestaMIBI gated myocardial tomography imaging to evaluate myocardial viability before and after peripheral blood stem cell transplantation. We scored the myocardial viability and measured left ventcle ejection fraction（EF）, myocardial defect index and uptake ratio of myocardial infarction. The results of pre-transplantion and post-transplantion were compared. [Results]After peripheral blood stem cell transplantation, territory of viability improved from 57.1 ± to 84.2± （ P 〈0.05）, EF of left ventricular increased from 42.1±3.6 to 50.2±2.7（ P 〈0.05）, uptake ratio of myocardial infarction increased from 22.4±7.3 to 39.7±9.7 （P〈0.05） and myocardial defect index declined from 10. 9±2.3 to 8.0±2.5 （P〈0.05）. [Conclusion]Peripheral blood stem cell transplantation can significantly improve myocardial viability. And nitroglycerin 99mTc-sestaMIBI gated myocardial tomography imaging play an important role in determining if peripheral blood stem cell transplantation can be done and evaluating its curative effect.