单光子发射型计算机断层心肌灌注显像对PTCA的疗效评估  

Evaluation the efficacy of percutaneous transluminal coronary angioplasty by SPECT myocardial perfusion tomography

作　　者：胡正清[1] 余枢[1] 米世簪[1] 马业新[1] 吴华[2] 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心内科 [2]同济医科大学附属同济医院核医学科

出　　处：《临床心血管病杂志》1997年第5期299-302,共4页Journal of Clinical Cardiology

摘　　要：用运动－静息单光子发射型计算机断层（SPECT）心肌灌注显像对18例经皮腔内冠状动脉成形术（PTCA）的患者追踪观察。结果显示，PTCA后患者运动耐量增加；放射性异常积分及靶心缺损范围明显降低，说明近期缺血明显改善。发现1例再缺血经冠状动脉造影提示再狭窄。8例多支病变中，有6例仅进行部分血运重建，SPECT显示缺血严重区域，相关血管多为严重病变血管。对12例心肌梗塞患者梗塞边线带99mTC－MIBI摄取比值测定表明，PTCA前摄取比值小于30％的室壁节段，术后摄取比值仍无增加，提示是否对其相应血管进行扩张应慎重考虑。表明SPECT对PTCA后近期疗效评估及探测再狭窄具有较高的实用价值。18 patients were observed by stress and rest SPECT before and after PTCA. It showed that 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 significantly improved,one of them was found recurrance of ischemia which was suggested restenosis by coronary angiography. In 8 cases with multiple lesion vessels, 6 of them were performed partial myocardial revascularization. It suggested serious and extensive ischemic segments shown by Exercise-SPECT were the 'culprit' vessel- In 12 cases with previous rnyocardial infarction,it was indicated that no changes was found in the segments of the ratios ＜30% of the peak uptake pre-PTCA. This suggested that we must be considerable to decide if the relevant coronary was dilated. In conclusion,SPECT can provide an efficient value for the evaluation of the recent efficacy of PTCA and detection of restenosis. In addition,it can help to select suitable patients before PTCA and judge the essentiality of dilating important lesion coronary vessel.

关 键 词：冠心病 PSECT 冠状动脉成形术 

分 类 号：R654.2[医药卫生—外科学] R814.42[医药卫生—临床医学]