脂质体携载前列地尔介入心肌灌注显像评价心肌梗死患者心肌活性  

^(99)Tc^m-MIBI imaging with liposomal prostaglandin E_1 infusion to detect viable myocardium in postmyocardial infarction patients

作　　者：郑勇[1] 缪蔚冰[2] 林军[2] 潘润阳[2] 蔡洪斌[1] 林好学[3] 

机构地区：[1]福建医科大学附属第一医院心内科,福州350005 [2]福建医科大学附属第一医院心核医学科,福州350005 [3]福建医科大学附属第一医院核医学科,福州350005

出　　处：《中华核医学杂志》2007年第2期91-93,共3页Chinese Journal of Nuclear Medicine

基　　金：福建省教育厅科研项目(JA03101)

摘　　要：目的对比分析脂质体携载前列地尔(Lipo-PGE_1)与硝酸异山梨酯(ISDN)介入^(99)Tc^m-甲氧基异丁基异腈(MIBI)心肌灌注显像检测梗死节段心肌活性的差异。方法 32例急性或陈旧性心肌梗死患者分别行静息、ISDN 介入及 Lipo-PGE_1介入心肌灌注显像;将左心室划分为16个节段,半定量分析3种心肌灌注显像图。结果静息心肌灌注显像时共有216个心肌节段(42.2%)灌注异常;ISDN 介入心肌显像时共有178个节段(34.8%)灌注异常,ISDN 介入后89个节段(41.2%,89/216)放射性摄取改善;Lipo-PGE_1介入心肌显像时共有184个节段(35.9%)灌注异常,Lipo-PGE_1介入后81个节段(37.5%,81/216)放射性摄取改善。2种介入心肌显像诊断符合率为89.8%。静息显像心肌放射性摄取得分为(15.3±3.3)分,ISDN 介入后减少为(10.5±1.4)分(P<0.01),Lipo-PGE_1介入后减少为(10.7±1.6)分(P<0.01)。结论与 ISDN 介入心肌灌注显像一样,Lipo-PGE_1介入心肌灌注显像可提高梗死节段存活心肌的检出率,且2种介入心肌显像具有相似的灵敏度。Objective The pharmacological efficiencies of liposomal prostaglandin E1 （ Lipo-PGE1 ） infusion and nitrate infusion on ^99Tc^m-methoxyisobutylisonitrile （MIBI） imaging detection of viable myocardium in post-myocardial infarction （MI） patients were compared in the current study. Methods Thirty-two patients with MI underwent ^99Tc^m-MIBI imaging at rest, nitrate infusion and Lipo-PGE1 infusion respectively. The semi-quantitative analysis of ^99Tc^mMIBI imaging was carried out in 16 segments over each left ventricle. Results Abnormal ^99Tc^m-MIBI distribution in 216 segments （42.2%） at rest, 178 segments （34. 8% ） at nitrate infusion, and 184 segments （35.9%） at Lipo-PGE1 infusion were identified. Among the 216 abnormal segments at rest, 89 （41.2%） and 81 （37.5%） were found improved after nitrate infusion and Lipo-PGE1 infusion respectively. Detecting viable myocardium with Lipo-PGE1 infusion imaging was accordant with that of nitrate infusion imaging in 89.8% of the cases. The mean uptake scores of abnormal segments at rest, nitrate infusion, and Lipo-PGE1 infusion were 15.3 ± 3.3, 10.5 ±1.4 （ P 〈 0.01 ） , and 10.7 ±1.6 （P 〈0.01）respectively. Conclusion Similar to nitrate infusion imaging, Lipo-PGE1 infusion imaging can be used for detection of viable myocardium in patients with MI.

关 键 词：心肌梗塞 脂质体 前列地尔 异山梨酯 硝酸 体层摄影术 发射型计算机 单光子 MIBI 

分 类 号：R542.22[医药卫生—心血管疾病] R817[医药卫生—内科学]