多巴酚丁胺^(99m)Tc-MIBI心肌断层显像对检测心肌梗塞后残余心肌缺血的价值  

Value of Dobutamine 99m Tc MIBI SPECT in Detecting Residual Ischemia after Myocardial Infarction

作　　者：陈步星[1,2] 徐成斌[1,2] 王伟民[1,2] 田雅文[1,2] 蒋宝琦[1,2] 赵红[1,2] 高伯山[1,2] 

机构地区：[1]北京医科大学人民医院心内科 [2]北京医科大学人民医院核医学科

出　　处：《中国医学影像学杂志》1997年第3期158-161,共4页Chinese Journal of Medical Imaging

摘　　要：目的：评价多巴酚丁胺９９ｍＴｃ－甲氧基异丁基异晴心肌断层显像（Ｄｏｂｕ－ＥＣＴ）检测心肌梗塞后残余心肌缺血的价值。材料与方法：６２例心肌梗塞患者在行冠状动脉造影时进行多巴酚丁胺心肌断层显像检查。结果：Ｄｏｂｕ－ＥＣＴ对心肌梗塞后残余心肌缺血检出率为７７％，高于多巴酚丁胺心电图负荷试验（Ｄｏｂｕ－ＥＣＧ）。无论是１支，还是２支或３支血管病变，Ｄｏｂｕ－ＥＣＴ对心肌梗塞后残余心肌缺血的检出率均高于Ｄｏｂｕ－ＥＣＧ（５６％，４％；８６％，２７％；１００％，４７％；Ｐ＜０．０１）。２１例急性心肌梗塞行溶栓治疗患者残余心肌缺血率为６７％，低于未行溶栓治疗患者（７２％）或陈旧性心肌梗塞患者（９４％），但差异无显著性。Ｄｏｂｕ－ＥＣＴ对非梗塞区心肌缺血的检出率为５６％。结论：多巴酚丁胺９９ｍＴｃ－甲氧基异丁基异晴心肌显像能够识别心肌梗塞后有无残余心肌缺血及其部位和范围。Purpose: To evaluate the value of dobutamine technetium 99m methoxy isobutyl nitrile (sestamibi) single photon emission computed tomography (Dobu ECT) in detecting residual ischemia after myocardial infarction. Materials and methods: Sixty two patients with confirmed myocardial infarction were studied with Dobu ECT at the time of coronary artery angiography. Results: The sensitivity of Dobu ECT in detecting residual ischemia of myocardial infarction was 76%, which was higher than dobutamine electrocardiography (Dobu ECG). Independent to the number of diseased vessel, Dobu ECT was superior to Dobu ECG in identifying residual ischemia (56%vs 4%, 86%vs 27%, 100%vs 47%, P<0.01, respectively). Incidence of residual ischemia in patients receiving thrombolytic therapy was 67%, lower than patients without thrombolysis (72%) or those with old myocardial infarction (94%), but the differences were not significant. Dobu ECT detected only 56% of ischemia of non infarct related myocardium. Conclusion: Dobu ECT is useful in qualitative, and quantitative detection and localization of residual ischemia after myocardial infarction.

关 键 词：心肌梗塞 多巴酚丁胺 心肌断层显像 心肌缺血 

分 类 号：R542.220.4[医药卫生—心血管疾病] R817.4[医药卫生—内科学]