单光子发射型计算机断层心肌灌注显像对经皮冠状动脉腔内成形术的近期疗效评估  

Evaluation of the Recent Efficacy of Percutaneous Transluminal Coronary Angioplasty by Single Photon Emission Computed Tomography Myocardial Perfusion Tomography

作　　者：胡正清[1] 余枢[1] 米世簪[1] 马业新[1] 吴华[1] 曾和松[1] 郭小梅[1] 

机构地区：[1]同济医科大学附属同济医院

出　　处：《中国循环杂志》1997年第3期198-200,共3页Chinese Circulation Journal

摘　　要：目的：探讨单光子发射型计算机断层摄影术（ＳＰＥＣＴ）心肌灌注显像在评估经皮冠状动脉腔内成形术（ＰＴＣＡ）治疗冠心病效果中的作用。方法：通过运动—静息心肌灌注显像，观察ＰＴＣＡ前后患者运动试验结果、心肌各心室壁节段放射性异常积分及靶心图缺损范围的变化。结果：ＰＴＣＡ后患者运动耐量增加；放射性异常积分及靶心图缺损范围明显缩小，说明近期缺血明显改善。８例多支病变患者中，有６例仅进行部分血运重建，心肌灌注显像示缺血严重、范围广的心肌节段，其相关血管多为“罪犯”（ｃｕｌｐｒｉｔ）血管。结论：ＳＰＥＣＴ心肌灌注显像对ＰＴＣＡ近期疗效评估具有较高的实用价值，并可为ＰＴＣＡ前判断需要扩张的关键性病变血管提供帮助。Objective:To evaluate the recent efficacy of percutaneous transluminal coronary angioplasty(PTCA) by single photon emission computed tomography(SPECT) myocardial perfusion tomography. Methods:The exercise duration,the ischemic score and the size of defect in blockout map of 18 patients were observed by stress and rest SPECT myocardial perfusion tomography before and after PTCA. Results:After PTCA,the exercise duration was greatly increased,the ischemic score and the size of defect in blockout map were reduced.It suggested that the recent ischemia was signficantly improved.Six of 8 cases with multiple lesion vessels,were performed partial myocardial revascularization.It suggested that the serious and extensive ischemia shown by EX SPECT were dominated by the “culprit” vessel. Conclusion:SPECT can provide an efficient value for the evaluation of the recent efficacy of PTCA and help to determine the necessity of dilating stenotic coronary artery before PTCA.

关 键 词：冠心病 CT 冠状动脉成形术 心肌灌注显像 

分 类 号：R654.2[医药卫生—外科学]