心肌灌注量化参数评价陈旧性心肌梗塞区心肌细胞活性

Assessment of viable myocardium by myocardium perfusion quantitative parameter in patients with old myocardium infarction

目的：探讨心肌灌注量化参数对陈旧性心肌梗塞区心肌细胞活性估测价值。材料和方法：７例陈旧性前壁心肌梗塞在成功地进行闭塞的左前降支ＰＴＣＡ术前及术后１周内行心肌灌注断层显像，由极坐标标准靶心图测得左室前壁、侧壁、下后壁、间壁心肌血流灌注异常范围（象素数）和异常程度评分（标准差值）等量化参数，并进行术前，术后配对比较。结果：由左前降支提供血运的左室前壁（靶心图上Ａ＋Ｂ区）心肌血流灌注异常范围ＰＴＣＡ术后为３６１±１６７，较术前（５０７±１９３）明显缩小（Ｐ＜００１）；异常程度评分术后为１８９７±１６００较术前（２４５６±１４３８）亦明显降低（Ｐ＜００５）。结论：可应用心肌灌注标准差靶心图中的量化参数评价陈旧性心肌梗塞区心肌细胞部分存活并经ＰＴＣＡ治疗有效。

Objective:To evaluate the clinical value of myocardium perfusion quantitative parameter in patients with old myocardium infarction in assessing myocardium viability.Materials and Methods:Seven patients with old anterior myocardium infarction underwent PTCA of the chrorically occluded LAD successfully.99m Tc-MIBI myocardial perfusion was obtained in those patients few days before and after PTCA.The quantitative parameter(abnormal area=pixels,abnormal severity=standard deviation)was shown by the Polar bull's eye plot.Results:The abnormal area of the myocardial perfusion in the region supplied by the LAD decreased significantly after successful PTCA(Area A+B from 50.7193 to 361167 P<001);the abnormal severity also reduced significantly(from 245.61438 to 18971600P<005).Conclusion:Assessing myocardial viability and the treatment of PTCA by myocardium perfusion quantitative parameter in patients with old myocardium infarction is a useful method.