利用门控心肌灌注显像评价冠状动脉旁路移植术疗效的研究  

ECG-gated myocardial perfusion imaging in evaluating the effect of coronary artery bypass grafting

作　　者：于建民[1] 张希全[2] 吴树明[2] 张供[2] 韩建奎[3] 

机构地区：[1]山东大学医医学院,山东济南250012 [2]山东大学医齐鲁医院心外科,山东济南250012 [3]山东大学齐鲁医院核医学科,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第4期340-342,345,共4页Journal of Shandong University:Health Sciences

摘　　要：目的:押探讨心电图门控心肌灌注断层显像在冠状动脉旁路移植术疗效评价上的应用价值。方法押12例冠状动脉旁路移植术的患者,于术前1周内、术后2～4周分别行静息门控单光子发射型计算机断层心肌灌注显像,比较手术前后心肌血流灌注指数、左室射血分数,左室容积、局部室壁运动等的变化,评价冠状动脉旁路移植术的效果。结果:冠状动脉旁路移植术后,平均缺血节段数无明显减少(4.83±1.94vs3.67±2.28,P>0.05),平均灌注指数显著降低(2.17±0.67vs1.20±0.58,P<0.05)。左室射血分数、左室收缩末容积与术前相比,差异无统计学意义,左室舒张末容积与术前相比,差异有统计学意义(98±27mlvs75±24ml,P<0.05)。平均室壁收缩增厚指数明显下降(1.52±0.42vs1.17±0.22,P<0.05)。结论:门控心肌灌注显像能准确评价冠状动脉旁路移植术疗效,为无创性评价冠状动脉旁路移植术的疗效提供了安全、可靠的新途径。Objective: To assess the value of ECG-gated single-photon emission computed tomography(SPECT)myocardial perfusion imaging in evaluating the effect of coronary artery bypass grafting (CABG). Methods: Twelve patients underwent rest ECG-gated SPECT myocardial perfusion imaging within a week before and 2～4 weeks after CABG, and were analysed the change of myocardial perfusion, left ventricle ejection fraction, end-systolic and end-diastolic volume, wall systolic thickening rate to evaluate the effect of CABG. Results: There was no significant decrease in the average number of ischemic segments after CABG (4.83 ±1.94 vs 3.67±2.28, P>0.05), but the mean perfusion index decreased significantly (2.17±0.67 vs 1.20±0.58, P<0.05). There was no significant improvement in left ventricular ejection fraction (0.52±0.18 vs 0.56±0.12, P>0.05). The end-diastolic volume lessened (98±27 vs 75±24, P<0.05). The mean systolic thickening index decreased from 1.52±0.42 to 1.17±0.22 (P<0.05). Conclusion: ECG-gated myocardial perfusion imaging can be used as a safe and non-invasive method for evaluating the effect of CABG.

关 键 词：冠状动脉疾病 冠状动脉分流术 门控心肌灌注显像 体层摄影术 发射型计算机 单光子 

分 类 号：R654.2[医药卫生—外科学] R817.4[医药卫生—临床医学]