^(99m)Tc-MIBI心肌显像定量分析用于判定急性心梗溶栓术后存活心肌的价值

The Value of Viable Myocardium by Dinitrate Quantitative ^(99m)Tc-MIBI SPECT Imaging after Thrombolytic Therapy in Patients with Acute Myocardial Infarction

目的 采用硝酸酯类药物介入心肌断层显像 ,研究急性心梗病人溶栓术后存活心肌的范围。方法 将32例接受急性溶栓术的病人分成溶栓再通组 (19例 )和未再通组 (13例 ) ,10天后行异舒吉介入的心肌断层显像 ,并分别计算出静态的及异舒吉介入的心肌缺损面积 (% )和体积 (% ) ,得出存活心肌的面积 (% )和体积 (% )。结果 溶栓再通组和未再通组比较 :静态显像缺损面积 (% )为 :32 0 4± 17 95和 5 2 13± 2 2 99(P <0 .0 5 ) ,异舒吉介入显像缺损面积 (% )为 :2 6 6 2± 15 13和 5 1 93± 2 1 10 (P <0 .0 5 ) ,存活心肌面积 (% ) 9 45± 6 43和 2 75± 3 5 7(P <0 0 5 )。静态显像缺损体积 (% )为 :2 8 45± 12 79和 39 5 6± 11 89(P <0 .0 5 ) ,异舒吉介入显像缺损体积 (% )为 :18 6 1± 16 5 2和 36 94± 11 35 (P <0 .0 5 ) ,存活心肌体积 (% )为 :9 84± 2 39和 2 6 2± 1 45 (P <0 .0 5 )。结论 急性心肌梗塞溶栓再通是否成功与存活心肌的面积、体积有明显的关系 ,并且异舒吉介入心肌显像定量分析方法判断存活心肌的范围有一定临床价值。

Objective To study the range of viable myocardium after thrombolytic therapy in patients with AMI, by myocardial perfusion tomography imaging with perfusion of isosorbide dinitrate. Methods A total of 32 AMI patients receiving thrombolytic therapy was divided into two groups, group A(19 patients) with repatency of the coronary artery, and group B(13 patients) with unrepatency of the coronary artery. 99m Tc\|MIBI SPECT combined with isosorbide dinitrate was performed ten days after, then figure out the defect area(%) and the defect volume(%) of viable myocardium. Results The group A and the group B were compared in pairs:Rest 99m Tc\|MIBI SPECT imaging showed that myocardial defect area(%) was [(32 04±17 95) VS (52 43±22 99). P <0 05], and myocardial defect area(%) of isosorbide dinitrate 99m Tc\|MIBI SPECT was [(26 62±15 53)VS(51 93±21 10)\%P\%<0 05]. Viable myocardial area(%) was [(9 45±6 43)VS(2 75±3 57),\%P\%<0 05]. Rest 99m Tc\|MIBI SPECT imaging showed that myocardial defect volume (%) was [(28 45±12 79)VS(39 56±11 89),\%P\%<0 05], and myocardial defect volume(%) of isosorbide dinitrate 99m Tc\|MIBI SPECT was [(18 61±16 52)VS(36 94±11 35)%,\%P\%<0 05]. Viable myocardial volume (%) was [(9 84±2 39)%VS(2 62±1 45)],\%P\%<0 05]. Conclusion It was related with the area and volume of viable myocardial that repatency of thrombolytic thearpy after AMI was success or not. The quantitative method that 99m Tc\|MIBI SPECT combined with isosorbide dinitrate had value on judging the range of viable myocardium. [