心肌梗死患者梗死部位存活心肌对心绞痛发作的影响

Effect of myocardial viability on angina pectoris in patients with Q wave myocardial infarction

目的 :探讨心肌梗死 (MI)患者梗死部位存活心肌对心绞痛发作的影响。方法 :6 3例Q波MI患者分别行静息、硝酸甘油 (NTG)介入99mTc MIBI心肌灌注显像 ,评价梗死部位的存活心肌。结果 :① 6 3例MI患者的 5 6 7个心肌节段中 ,静息心肌显像共有 2 39个节段 (4 2 .15 % )灌注异常 ,含服NTG 1.0mg后介入心肌显像 2 39个节段中有 97个节段得到改善 ,占总异常的 4 0 .5 8% ;②不稳定型心绞痛者存活心肌检出率为 5 9.80 % ,稳定型心绞痛者为 2 9.2 9% ,两者比较差异有显著性意义 (P <0 .0 1)。结论 :①硝酸酯类药物介入显像可以提高严重灌注缺损区存活心肌的检出率 ;②MI后 ,有心绞痛发作 。

Objective:To assess the influence of myocardial viability on angina pectoris in patients with Q wave myocardial infarction. Methods:Technetium-99m-sestamibi imaging with nitroglycerin sublingual was used to evaluate myocardial viability in 63 patients with Q wave myocardial infarction. Results:①In 63 patients,239 segment was decreased in rest perfusion imagining, 97 segment was improved in nitroglycerin intervention imaging, the detection of viability myocardium was 40.58%.②The rate of detection of viability myocardium in unstable angina pectoris was higher than that in the group of stable angina pectoris ( 59.80% vs 29.29% ,P< 0.01).Conclusion:①The rate of finding viability myocardium with Technetium-99m-sestamibi imaging is in ncreased by using nitroglycerin sublingual.②Regardless of acute myocardial infarction or old myocardial infarction , patients with unstable angina pectoris has more viability myocardium than that with stable angina pectoris .