摘要
目的:探讨双核素心肌同步显像(DISA)在心肌梗死患者治疗策略和疗效评估中的价值。方法:回顾性分析行DISA的87例心肌梗死患者,选择其中在治疗前后均成功进行DISA的63例患者进入本研究,所有患者均在术前2~3周、术后11~13周行DISA。根据治疗方法和有否存活心肌,分为A组:冠脉血运重建术(A1组:有存活心肌,A2组:无存活心肌);B组:冠脉血运重建术+干细胞移植(B1组:有存活心肌,B2组:无存活心肌);C组:干细胞移植(C1组:有存活心肌,C2组:无存活心肌)。采用SPSS13.0软件进行数据处理。结果:①63例患者中有存活心肌的30例,其中A1组16例,B1组6例,C1组8例;无存活心肌的33例,其中A2组9例,B2组7例,C2组17例。②A2组治疗前后,心肌梗死区心肌血流灌注和代谢均无明显改善,灌注显像或代谢显像的DF值比较,差异均无统计学意义(P值均>0.05),其余5组治疗后均有不同程度改善,DF值比较差异均有统计学意义(P值均<0.05);心肌存活组经治疗后血流灌注和代谢的改善程度,明显优于无心肌存活组,差异有显著统计学意义(P值均<0.05),同时B1组优于A1和C1组,B2优于A2和C2组,差异均有统计学意义(P值均<0.05或<0.01)。结论:①DISA显像能很好地评估心肌存活情况,有助于对心肌梗死患者治疗策略的选择;②DISA显像能较好地观察和评价梗死心肌治疗后的改善程度。
Objective： To investigate the value of 99mTc-MIB/18F-FDG-dual-isotope simultaneous acquisition（DISA） in diagnosis and treatment of patients with myocardial infarction.Methods： Sixty-three patients with myocardial infarction who underwent DISA before and after treatment were enrolled in the study.All cases were divided into subgroups based on different treatment and myocardial viability：Group A1（n=16） with coronary revascularization and viable myocardium,A2（n=9） same as A1 but no viable myocardium;B1（n=6） with coronary revascularization ＋ stem cell transplantation and viable myocardium,B2（n=7） same as B1 but no vital myocardium;C1（n=8） with stem cell transplantation and viable myocardium,C2（n=17） same as C1 but on viable myocardium.The changes of uptake rate of 99mTc-MIB/18F-FDG before and after treatment were analyzed with SPSS 13.0 software.Results： There were statistical significances in DF value of 99mTc-MIBI or 18F-FDG imaging before and after treatment in all groups（P0.05）,except Group A2（P0.05）.The improvement of blood perfusion and metabolism in cardiac survival groups was more marked than that in non-cardiac survival groups after treatment（P0.05）.Furthermore,Group B1 was superior to Groups A1 and C1;Group B2 was superior to Group A2 and Group C2（P0.05 or0.01）.Conclusions： 99mTc-MIBI/18F-FDG DISA can detect myocardial viability and is of value for patients with myocardial infarction to choose appropriate therapeutic strategies.The degree of cardiac improvement after treatment can be evaluated by DISA.
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2010年第5期530-533,共4页
Journal of Zhejiang University(Medical Sciences)
