摘要
目的:探讨心肌梗死(MI)患者经皮冠状动脉介入治疗(PCI)前行硝酸甘油(NTG)介入心肌断层显像的临床价值。方法:32例MI患者PCI前行99mTc-MIBI静息和NTG介入心肌显像,术后3个月时复查静息心肌显像,并进行对比分析;术前和术后3个月时均应用超声心动图检测心功能,两者进行对比分析。结果:32例患者静息显像共有116个节段(40·28%)心肌核素摄取异常,NTG介入心肌显像后有66个节段(56·90%)呈可逆性缺损,50个节段(43·10%)呈不可逆性缺损;PCI后68个心肌节段(58·62%)心肌灌注得到改善,术前NTG介入显像显示的66个可逆性缺损节段,术后60个节段(90·91%)心肌灌注改善,术前NTG介入显像显示的50个不可逆性缺损节段,术后8个节段(16·0%)心肌灌注改善,改善与未改善节段比较均差异有统计学意义(P<0·05);19例有存活心肌的患者PCI后其左室射血分数较术前明显增高(P<0·01),左室舒张末期容积和收缩末期容积均较术前有很大程度的降低(P<0·01);而13例无存活心肌的患者,上述指标在术前和术后差异无统计学意义(P>0·05)。结论:MI患者PCI前常规行NTG介入99mTc-MIBI心肌显像对是否进行PCI治疗有决策性指导作用。
Objective： To investigate the clinical values of ^99mTc-MIBI SPECT imaging after nitroglycerin administration on decision-making of patients with myocardial infarction for pecutaneous coronary interventions. Method： Thirty-two patients with myocardial infarction were performed with ^99mTc-MIBI SPECT rest imaging and nitroglycerin intervening imaging before PCI , rest imaging was repeated at 3 months after PCI, images of which were compared and analyzed. Heart function of all patients were detected by echocardiograms before PCI and at 3 months after PCI , data of which were compared and analyzed. Result： The 116 abnormal segments were detected in 32 patients, which included 66 reversible defect segments （56.90%） and 50 irreversible defect segments （43.10%）after nitroglycerin intervening imaging. Of 116 abnormal segments after PCI, 68 segments（58.62%） showed improved perfusion. Of 66 reversible defect segments before PCI, 60 segments（90.91%） showed improved perfusion. Of 50 irreversible defect segments before PCI, only 8 segments（16.9%） showed improved perfusion（ P 〈0.05）. Left ventricular fraction of 19 patients with viable myocardiums increased after PCI than that before PCI（ P 〈0.01）. End diastolic volume and end systolic volume decreased after PCI（ P 〈0.01）. There was no difference among these data in 13 patients without viable myocardiums（ P 〉0.05）. Conclusion：The results of NTG intervening ^99mTc-MIBI myocardial imaging play a significant decision-making role on the selection of pa- tients with myocardial infarction for PCI.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2005年第11期671-673,共3页
Journal of Clinical Cardiology
关键词
心肌梗死
冠状动脉介入治疗
放射性核素显像
硝酸甘油
Myocardial infarction
Pecutaneous coronary interventions
Radionuclide imaging
Nitroglycerin
