2型糖尿病合并急性心肌梗死患者心肌灌注显像及冠脉造影特点分析

Characteristics of myocardial perfusion imaging and coronary artery angiography in patients of NIDDM complicated with AMI

目的 探讨 2型糖尿病 (2DM)合并急性心肌梗死患者的心肌灌注断层显像和冠状动脉病变的特征性改变。方法 2 5例 2DM合并急性心肌梗死患者 ,随机选取同期住院的单纯冠心病急性心肌梗死患者 10例作为对照。所有患者均行核素心肌灌注显像 (静态和硝酸甘油介入心肌断层显像 )及冠状动脉造影。结果 2 5例 2DM合并心肌梗死者冠状动脉造影 3支病变占 6 0 % ,明显高于对照组 (4 0 % ) ;心肌灌注检出的放射性缺损节段数为 32 .2 5 % (12 9/ 40 0 ) ,而对照组为 15 .6 2 % (2 5 /16 0 )。结论 2DM合并急性心肌梗死患者呈广泛多节段灌注缺损 ,冠状动脉多为多支病变。

Objective To investigate the characteristic changes of myocardial perfusion imaging and coronary artery angiography in patients of acute myocardial infarction (AMI) with underlined type 2 diabetes mellitus. Methods 25 type 2diabetes mellitus patients were enrolled for having clinical manifestation of AMI.Ten inpatients with AMI of simple coronary heart disease origin were served as controls. All subjects underwent both myocardial perfusion imagings (resting and nitroglycerine invention) and coronary artery angiography. Results Compared to controls (40%), type 2 diabetes mellitus+AMI group had higher rate of multivessel disease (60%). For type 2 diabetes mellitus+AMI patients, 129/400 segments (32.25%) showed fixed defect, 25/160 segments (15.62%) in controls. Conclusions For type 2 diabetes mellitus+AMI group, myocardial perfusion defects are widely distributed and multivessel or severe stenosis is more often presented. Good correlation exists between abnormal segments and angiographic lesions in both the number of segments involved and the severity of the lesions. Radionuclide myocardial perfusion is therefore considered a useful screening test not inferior to angiography, especially for those who are not tolerent enough to undergoing angiography.