^(99)Tc^m-MIBI动力学变化与大鼠缺血-再灌注心肌存活的相关性研究  

Study on the relationship between the changes of ^(99)Tc^m-MIBI kinetics and the myocardial viability in ischemic reperfused rat heart

作　　者：刘杰[1] 李亚明[1] 刁尧[2] 

机构地区：[1]中国医科大学附属第一医院核医学科,沈阳110001 [2]中国医科大学附属第一医院同位素实验中心,沈阳110001

出　　处：《中华核医学杂志》2005年第1期17-21,共5页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨用99Tcm 甲氧基异丁基异腈 (MIBI)动力学变化评价心肌存活的价值。方法1 5只离体Krebs Henseleit(KH)液灌注的鼠心脏 ,随机分成 3组 :对照组 (5只 ) ,有葡萄糖的缺血 再灌注组 (IR +G组 ,5只 ) ,无葡萄糖的缺血 再灌注组 (IR -G组 ,5只 )。用含99Tcm MIBI(1 4 . 8MBq)的KH液灌注 ,观察 4. 0min的摄取和清除。用肌酸激酶 (CK)分析、氯化三苯四唑 (TTC)染色和透射电镜 (TEM)分析研究心肌损伤程度 ,用放射自显影 (ARG)观察99Tcm MIBI在心肌内的分布。结果　99Tcm MIBI的摄取 [每克组织百分注射剂量率 (%ID g) ]在IR +G组为 (7. 0 9± 0. 97) %ID g,IR -G组为 (66 .4± 0 . 6 8) %ID g ,对照组为(1. 1 4 4± 1 . 79) %ID g ,IR -G组与IR +G组相比摄取量差异无显著性 (P >0 . 0 5 ) ,IR -G组和IR +G组与对照组相比均显著降低 (P <0 0 5 )。IR -G组99Tcm MIBI清除分数为 (72. 75± 9 .89) %,远高于对照组 [(2 0 . 6 8± 1. 92 ) %]和IR +G组 [(2 1 . 0 3± 3 6. 8) %,P均 <0 . 0 5 ],对照组与IR +G组的差异无显著性。99Tcm MIBI的 4 0min清除末滞留率在IR -G组 [(1. 82± 0 .73) %ID g]和IR +G组 [(5 . 6 1±0 . 89) %ID g]远小于对照组 [(9 .0 9± 1 . 5 7) %ID g ,P <0. 0 5 ],IR -G组也?Objective To study the relationship between the uptake and clearance of 99 Tc m methoxyisobutylisonitrile (MIBI) and the myocardial viability, and to evaluate the role of 99 Tc m MIBI kinetics in assessing myocardial viability. Methods Fifteen isolated Krebs Henseleit (KH) perfused rat hearts were divided into 3 groups at random: control (flow, 12 ml/min; n =5), ischemic reperfused with glucose (IR+G, n =5), and ischemic reperfused without glucose(IR-G, n =5); 99 Tc m MIBI KH(14.8 MBq)was perfused for 40 min followed by KH perfusion for 40 min in order to study the uptake and clearence. The injuries were studied by creatine kinase (CK)assay, triphenyltetrazolium chloride (TTC) staining and transmission electron microscope (TEM) analysis and the distribution of 99 Tc m MIBI in the myocyte was studied by autoradiography. Results 99 Tc m MIBI uptake(percent injected dose pergram) was not significantly different in the IR+G [(7.09±0.97)%ID/g] and IR-G[(6.64±0 68)%ID/g] group compared with each other ( P >0.05). Clearance fraction of 99 Tc m MIBI was higher in the IR-G group[(72.75±9.89)%, P <0.05] than in the control[(20.68±1.92)%] and IR+G [(21.03±3.68)%] groups, but there was no significant difference between control and IR+G group. At the end of 40 min clearance ,retention rate (percent injected dose pergram) of 99 Tc m MIBI in the IR-G[(1.82±0.73)%ID/g ]and IR+G[(5.61±0.89)%ID/g] groups were significantly less than that in the control group [(9. 09±1.57)%ID/g, P <0.05], and the retention rate in the IR-G group was less than that in the IR+G group ( P <0.001). CK assay, triphenyltetrazolium chloride staining, and TEM analysis demonstrated more serious myocardial damage in IR-G group than in IR+G group. The end 99 Tc m MIBI activity was highly correlated with myocardial viability determined by TTC ( r =0.84, P <0.05) and CK assay ( r =-0.97, P <0.05), and autoradiography demonstrated that 99 Tc m MIBI dist

关 键 词：^99TC^M-MIBI 对照组 IR 缺血-再灌注 心肌存活 CK 心肌损伤 KH 氯化 三苯 

分 类 号：R817[医药卫生—影像医学与核医学]