摘要
目的 利用99 Tcm-MIBI静息MPI和心电门控18 F-FDG心肌代谢PET显像评价缺血性心肌病患者心肌损伤与心室收缩的同步性,并探讨两者间的关系.方法 回顾性分析2015年7月至2015年12月间阜外医院113例确诊的缺血性心肌病患者[男100例,女13例;平均年龄（58±10）岁],所有患者均于2 d内接受99 Tcm-MIBI静息MPI和门控18 F-FDG心肌代谢PET显像.据17节段分析法分别对慢性心肌缺血节段及心肌梗死节段进行评分,计算心肌缺血总分（TIS）和心肌梗死总分（TSS）.相位分析获得左心室同步化参数：相位分布带宽（BW）和相位SD.采用Pearson相关分析、logistic回归处理数据.结果 93例有心肌梗死改变的患者TSS与BW、SD均相关（r值：0.517和0.470,均P〈0.01）,其中34例单纯心肌梗死患者TSS与BW、SD亦相关（r值：0.647和0.578,均P〈0.01）.79例慢性缺血患者TIS与BW、SD相关（r值：0.392和0.378,均P〈0.01）,但其中20例单纯慢性缺血患者TIS与BW、SD却未见相关性（r值：0.002和-0.003,均P〉0.05）.Logistic回归分析示左心室心肌梗死节段数和TSS对不同步化有影响.结论 心肌梗死是影响左室收缩运动不同步化的重要原因,而慢性心肌缺血对心室收缩运动不同步化未见明显影响.
Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy （ ICM） using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients （ 100 males, 13 females;average age （58±10） years） underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score （ TIS） and total scar score （ TSS） of 17 segments were calcu-lated in each patient. The phase bandwidth （ BW） and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction （ r values：0. 517, 0.470, both P〈0.01） and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia （ r values： 0. 647, 0. 578, both P〈0.01） . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia （ r values：0.392, 0.378, both P〈0.01） , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction （ r values： 0. 002, -0. 003, both P〉0. 05） . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.
作者
李树恒
田月琴
孙晓昕
郭风
张海龙
何作祥
方纬
Li Shuheng Tian Yueqin Sun Xiaoxin Guo Feng Zhang Hailong He Zuoxiang Fang Wei(Department of Nuclear Medicine, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Center of Cardiovascular Disease, Beijing 100037, China)
出处
《中华核医学与分子影像杂志》
北大核心
2017年第10期623-626,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
