用心肌灌注显像靶心图定量分析评价AMI患者骨髓干细胞移植术疗效  

Usefulness of bull's eye quantification of ^(99)Tc^m-MIBI myocardial SPECT in patients of myocardial infarction treated with bone marrow stem cell transplantation

作　　者：谢建[1] 闫新慧[1] 孙海舟[1] 王子超[2] 高传玉[2] 

机构地区：[1]河南省人民医院核医学科,郑州450003 [2]河南省人民医院心内科,郑州450003

出　　处：《中华核医学杂志》2007年第5期281-283,共3页Chinese Journal of Nuclear Medicine

基　　金：河南省重大科技攻关项目(0422030300)

摘　　要：目的探讨靶心图上心肌灌注缺损区定量分析方法的可靠性、重复性及应用价值。方法 16例急性心肌梗死(AMI)行自体骨髓单个核细胞移植治疗的住院患者,于治疗前、治疗后45和90 d 行^(99)Tc^m-MIBI 静息心肌灌注显像。在靶心图上勾画缺损区(在左心室靶心图中放射性计数低于40%的区域),并进行定量分析。结果 (1)不同操作者所得 ROI 结果之间的差异无统计学意义(t=0.52,P>0.05)。(2)治疗后45 d 心肌灌注缺损区面积较治疗前缩小34.32%,差异有统计学意义(t=2.83,P<0.05);治疗后90 d 心肌灌注缺损区面积较治疗后45 d 缩小14.77%,差异有统计学意义(t=2.51,P<0.05)。示自体骨髓单个核细胞移植对缺血心肌的恢复有一定疗效,能够缩小梗死面积,且自体骨髓单个核细胞冠状动脉内移植治疗 AMI 的疗效在移植后早期(45 d 内)即有体现。(3)面积百分比是观察心肌灌注变化的重要定量指标。结论该方法对心肌病变范围及严重程度能准确定量;对评价 AMI 骨髓干细胞移植术疗效有一定的价值。Objective The quantitative bull＇s eye analysis was used in this study to investigate the clinical value of stem cell transplantation in treating myocardial perfusion defects. Methods Sixteen patients with myocardial infarction underwent rest myocardial SPECT with ^99Tc^m-MIBI before and after bone marrow monocytes transplantation. The changes on myocardial perfusion defects （ defined as 〈 40% of the maximum activity） were quantitatively evaluated by bull＇s eye analysis in all cases. Results （ 1 ） The interpreter difference on the perfusion defect size was insignificant （ t = 0.52, P 〉 0. 05 ）. （ 2 ） Myocardial perfusion defect size decreased by 34.32% （ t = 2.83,P 〈 0.05 ） at 45 d, and by 14.77% （ t = 2.51, P 〈 0. 05 ） at 90 d after transplantation. The findings suggested that bone marrow monocytes transplantation could diminish the sizes of myocardial infarction, especially within 45 d. （ 3 ） Quantification of myocardial perfusion defect size was an effective index for myocardial perfusion. Conclusion Quantitative analysis of ^99Tc^m-MIBI myocardial SPECT by bull＇s eye analysis is a reliable method in the evaluation of therapeutic effects in patients with coronary artery disease.

关 键 词：心肌梗塞 于细胞 骨髓移植 体层摄影术 发射型计算机 单光子 

分 类 号：R542.22[医药卫生—心血管疾病]