| 摘要: |
| 目的：观察经皮冠状动脉介入治疗（PCI）术前后99mTc-MIBI心肌灌注显像的变化，筛选PCI疗效可靠的预测指标。方法：48例心肌梗死患者PCI前分别行静息/运动/硝酸甘油介入99mTc-MIBI心肌灌注显像，PCI术后1～2周复查运动和静息99mTc-MIBI心肌灌注显像，以（术后静息心肌灌注显像缺损计分-术前运动心肌灌注显像缺损计分）/术前运动灌注缺损计分作为PCI术的疗效，以(术前静息心肌灌注缺损计分-术前运动心肌灌注缺损计分)/术前运动灌注缺损计分作为术前有功能存活心肌的指标、以（术前运动心肌灌注缺损计分—术前硝酸甘油心肌灌注缺损计分）/术前运动灌注缺损计分作为潜在有功能存活心肌的指标、以（术前静息心肌灌注缺损计分—术前硝酸甘油心肌灌注缺损计分）/术前静息灌注缺损计分作为药物可改善存活心肌指标，后三者分别与PCI术后疗效作直线相关分析，筛选PCI疗效可靠的预测指标。结果：PCI后运动和静息心肌灌注显像比术前均明显改善（P<0.01）。相关分析结果表明，后三者与前者相关系数分别为：r1=0.63，P<0.01；r2=0.94，P<0.000 1；r3=0.92，P<0.000 1，提示潜在有功能存活心肌与PCI疗效相关性最佳。结论：心肌梗死患者PCI前进行静息/运动/硝酸甘油介入99mTc-MIBI心肌灌注显像很有必要，潜在有功能存活心肌可作为筛选PCI患者和预测PCI疗效的可靠指标。 |
| 关键词: 99mTc-MIBI 心肌灌注显像；经皮冠状动脉介入治疗；治疗结果；心机梗死 |
| DOI：10.3724/SP.J.1008.2008.00531 |
| 投稿时间：2007-09-20修订日期：2007-09-20 |
| 基金项目: |
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| 99mTc-MIBI myocardial perfusion image in predicting therapeutic effect of percutaneous coronary intervention |
| SUN Zhi-jun1*,GAI Lu-yue1,WANG Yu1,TIAN Jia-he2,ZHANG Shu-wen2,MENG Fan-hua1,LU Xi-lie1 |
| (1.Department of Cardiology, General Hospital of PLA，Beijing 100853,China;2.Department of Nuclear Medicine,General Hospital of PLA，Beijing 100853) |
| Abstract: |
| Objective：To observe the 99mTc-MIBI myocardial perfusion images in patients with myocardial infarction before/after percutaneous coronary intervention (PCI),so as to screen for the reliable predictors for the therapeutic effect of PCI.Methods:Forty-eight patients with myocardial infarction receiving PCI were included in this study.The rest,stress and nitroglycerin myocardial perfusion imaging tests were performed before PCI.The stress and rest myocardial perfusion imaging tests were repeated 1-2 weeks after PCI.The value of（rest 99mTc-MIBI imaging in myocardial perfusion scores after PCI-stress 99mTc-MIBI imaging in myocardial perfusion scores before PCI）/ stress 99mTc-MIBI imaging in myocardial perfusion scores before PCI was taken as the curative effect of PCI; the value of（rest 99mTc-MIBI imaging in myocardial perfusion scores before PCI-stress 99mTc-MIBI imaging in myocardial perfusion scores before PCI）/ stress 99mTc-MIBI imaging in myocardial perfusion scores before PCI was taken as the functional viable myocardium; the value of (stress 99mTc-MIBI imaging in myocardial perfusion scores before PCI-nitroglycer 99mTc-MIBI imaging in myocardial perfusion scores before PCI）/ stress 99mTc-MIBI imaging in myocardial perfusion scores before PCI was taken as potential functional viable myocardium; and the value of（rest 99mTc-MIBI imaging in myocardial perfusion scores before PCI-nitroglycer 99mTc-MIBI imaging in myocardial perfusion scores before PCI）/ rest 99mTc-MIBI imaging in myocardial perfusion scores before PCI was taken as drug relative viable myocardium. To screen the proper predictors for therapeutic effects, linear correlation analysis was performed between the curative effect of PCI and the latter 3 factors.Results:Stress and rest myocardial perfusion defects were significantly improved after PCI (P<0.01).Correlation analysis showed that the curative effect of PCI was correlated with the latter 3 factors,with the correlation coefficients being r1=0.63,P<0.01,r2=0.94,P<0.000 1,and r3=0.92,P<0.000 1,respectively,indicating that the potential functional viable myocardium had the best correlationship with PCI.Conclusion: It is necessary to perform the rest,stress and nitroglycerin myocardial perfusion imaging tests in patients with cardiac infarction.The functional viable myocardium is a reliable index in screening the patients suitable for PCI and in predication of the therapeutic effect. |
| Key words: 99mTc-MIBI myocardial perfusion imaging percutaneous coronary intervention treatment outcome myocardial infarction |
