多巴酚丁胺^(99m)锝心肌断层显象评价冠状动脉介入性治疗的效果  

Dobutamine techntium 99 m MIBI spect in evaluating the effects of coronary intreventional management

作　　者：陈步星[1] 徐成斌[1] 王伟民[1] 田雅文[1] 高伯山[1] 

机构地区：[1]北京医科大学人民医院心内科

出　　处：《中华医学杂志》1997年第3期187-190,共4页National Medical Journal of China

摘　　要：用多巴酚丁胺９９ｍ锝－ＭＩＢＩ（ｍｅｔｈｏｘｙｉｓｏｂｕｔｙｌｎｉｔｒｉｌｅ）心肌断层显象（Ｄｏｂｕ－ＥＣＴ）评价冠心病介入性治疗的效果。方法对３２例冠心病患者在冠状动脉介入治疗的术前、术后３～６个月行多巴酚丁胺心肌显象。多巴酚丁胺以５～４０μｇ．ｋｇ－１／ｍｉｎ，每级剂量间隔３分钟。在最大剂量时注射７４０ＭＢｑ９９ｍ锝－ＭＩＢＩ，１小时后行心肌断层显象。２４小时后再注射等量３９９ｍ锝－ＭＩＢＩ行静态心肌显象。结果术前显示１１６个异常室壁节段，术后显示７９个节段缺血消失或缺血改善，术前心肌显象有明显可逆性心肌缺损节段，治疗有效率为７５％；而术前仅呈固定缺损节段，治疗有效率为４３．８％（Ｐ＜０．０１）。术前心脏断层显象有明显可逆心肌缺损病例，７７．８％（２１／２７）术后心肌缺血消失或改善，２２．２％（６／２７）心肌缺血无改善或缺血范围扩大，其中５例经冠状动脉造影证实原有扩张部位再狭窄。结论多巴酚丁胺９９ｍ锝－ＭＩＢＩ心肌显象可用于评价冠心病介入性治疗的效果，在随访中可发现再狭窄。Objective To evaluate the effects of coronary interventional management by dobutamine 99m Tc MIBI single photon emission computed tomography(Dobu ECT).Methods Dobu ECT was performed in pre and post interventional management of 32 patients.Dobutamine was administered intravenously at incremental rates from 5 to 40 μg·kg 1 .imn 1 at 3 minute intervals.At the hightest infusion rate,20mCi 99m Tc MIBI was injected intravenously,and tomographic imaging was performed after one hour.Rest imagings were taken after 24 hours with asecond dose of 99m Tc MIBI.Results In 32 patients accepting interventional treatment,within 3～6 months follow up,the results of Dobu ECT showed a total effectiveness rate of treatment was 68.1%.27 patients of whose Dobu ECT showed significant reversible defects before procedure,the effectireness rete was 77.8%(21/26)6,still had reversible is chemia within the follow up period,and restenoses of 5 patients were confirmed by angiography.We also compared the effect of percutaneous transluminal coronaryangioplasty(PTCA)with intracoronary stenting using Dobu ECT.The results showed that intracoronary stenting was more beneficial than PTCA(81.3%vs43.8%, P <0.05). Conclusion Dobu ECT can be used to evaluate the effect of interventional management and detecct restenosis after procedure

关 键 词：多巴酚胺 核素成象 血管造影术 冠状动脉疾病 

分 类 号：R541.405[医药卫生—心血管疾病] R817.52[医药卫生—内科学]