^(99m)Tc-MIBI心肌断层显像对急性心肌梗塞早期静脉溶栓的疗效观察  

Evaluation of effects of early intravenous thrombolytic therapy in acute myocardial infarction with 99m Tc MIBI tomography imaging

作　　者：张中正[1] 薛铮[1] 秦富中 张水旺[1] 王陆建[1] 张承刚[1] 李思进[1] 刘建中[1] 李险峰[1] 

机构地区：[1]山西医科大学第一医院心内科

出　　处：《中华核医学杂志》1997年第3期150-152,共3页Chinese Journal of Nuclear Medicine

摘　　要：为观察急性心肌梗塞（ＡＭＩ）早期静脉溶栓的疗效，应用静态９９ｍＴｃ甲氧基异丁基异腈心肌断层显像，对２２例ＡＭＩ病人进行了观察。结果显示，９例溶栓再通病人由溶栓前平均９１±３３分降至３７±２２分（ｔ＝４０８５，Ｐ＜００１）。溶栓后２０个缺损节段中６个恢复正常，１０个明显改善。而这些节段为ＥＣＧ检查所示的梗塞部位。未溶栓组２次心肌显像变化不大。因此，静息心肌显像可观察ＡＭＩ病人溶栓前后心肌缺血有无改善，也可为判断冠状动脉再通提供影像学基础，具有一定的应用前景。PURPOSE To evaluate the effects of early intravenous thrombolytic therapy in acute myocardial infarction (AMI) with 99m Tc MIBI tomography imaging METHODS 22 patients with AMI were observed using 99m Tc MIBI rest myocardial tomography imaging The semiquantitative score of myocardial 99m Tc MIBI uptake was expressed with a four point scoring system RESULTS The findings showed in patients in whom reperfusion was achieved, mean scores decreased from 9 1±3 3 before thrombolytic therapy to 3 7±2 2 (t=4 085,P<0 01) In 20 defect segments after thrombolytic therapy, 6 defect segments restored to normal and 10 defect segments significantly improved The change of these 99m Tc MIBI perfusion defect segments correlated with that of the ECG determined infarct site The comparison between the first and the second myocardial imaging in the non thrombolytic treatment group was statistically insignificant CONCLUSIONS The potential advantages of rest myocardial imaging in AMI before and after thrombolytic therapy not only provide an information for assessing the extent of improvement of myocardial ischemia but also provide an imaging basis for determining coronary artery reperfusion

关 键 词：心肌梗塞 放射性核素 显像 溶栓治疗 锝^99M 

分 类 号：R542.220.5[医药卫生—心血管疾病]