肥厚型心肌病患者心肌MIBI清除率的临床研究  

Evaluation of ^99Tc^m-MIBI washout rate in hypertrophic cardiomyopathy

作　　者：孙牧川[1] 李亚明[1] 李娜[1] 刘浩[1] 尹雅芙[1] 李德顺[1] 梁晓光[2] 王勃[2] 

机构地区：[1]中国医科大学附属第一医院核医学科,沈阳110001 [2]中国医科大学附属第一医院循环内科,沈阳110001

出　　处：《中华核医学杂志》2008年第6期372-374,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨肥厚型心肌病（HCM）患者心肌^99Tc^m-甲氧基异丁基异腈（MIBI）早、晚期清除率的变化以及早、晚期清除率与左室壁心肌肥厚程度的关系。方法对临床确诊为HCM的15例患者行^99Tc^m-MIBI静态平面及门控SPECT显像。比较HCM患者^99Tc^m -MIBI早期（注药后90min）及晚期（注药后4h）清除率与健康对照组（健康志愿者12名）间的差异（采用SPSSt3．0软件，行t检验），并对早、晚期清除率与左室壁心肌肥厚程度行Pearson直线相关性分析。结果HCM患者组早期及晚期心肌^99Tc^m-MIBI清除率分别为（27．77±2．60）％及（42．66±3．30）％，健康对照组分别为（18．90±3．70）％及（31．27±4．04）％，2组比较差异均有统计学意义（t值分别为-7．320，-8．069，P均〈0．01）。HCM患者组左室壁肥厚心肌最大厚度为（26．53±6．57）mm，健康对照组为（15．92±1．29）mm，2组比较差异亦有统计学意义（t值为-6．110，P〈0．01）。HCM早期及晚期清除率与左室壁肥厚心肌最大厚度间有较好的相关性（r值分别为0．611及0．873，P〈0．05和〈0．01）。结论HCM患者心肌^99Tc^m-MIBI早期及晚期清除率明显高于健康对照组，且早、晚期清除率与左室壁心肌肥厚程度均有一定的相关性。Objective The aims of this study were two. One was to investigate the changes in early and late washout rates of 99Tcm-methoxyisobutylisonitfile （MIBI） in patients with hypertrophic eardiomyopathy （HCM） and the other was to analyze the relationships between early and late washout rates and the hypertrophic wall thickness of left ventricle. Methods Fifteen patients who were clinically diagnosed with HCM underwent ^99Tc^m-MIBI static planar and gated SPECT imaging. Early （90 min after the intravenous injection） and late （4 hafter the intravenous injection） washout rates of ^99Tc^m-MIBI between HCM and normal control groups （n = 12） were compared. Linear correlation （Pearson） was assessed between early and late washout rates and the hypertrophic wall thickness of left ventricle measured by gated SPECT. Results Statistically higher early and late washout rates of ^99Tc^m-MIBI were observed in HCM than in normal control groups [ （27. 77 ± 2.60）% vs （18.90±3.70）%, t= -73.20, P〈0.01 and （42.66±3.30） vs （31.27 ±4.04）%, t = -8.069, P〈 0. 01 ]. Moreover, statistically higher maximum wall thickness over left ventricle was observed in HCM than in normal control groups [ （26.53 ± 6.57） mm vs （ 15.92 ± 1.29） mm, t = - 6. 110, P 〈 0.01 ]. Furthermore, significantly positive correlation between early and late washout rates and the maximal wall thickness of left ventricle obtained by gated SPECT was demonstrated （ r = 0. 611, P 〈 0.05 and r = 0. 873, P 〈 0.01 ）. Conclusions Both early and late washout rates of ^99Tc^m-MIBI and maximum wall thickness over left ventricle were significantly higher in patients with HCM than in control groups. The higher the maximum wall thickness over left ventricle, the higher early and late washout rates in 99^Tc^m-MIBI studies was noted.

关 键 词：心肌病 肥大性 门控血池显像 体层摄影术 发射型计算机 单光子 MIBI 

分 类 号：R686[医药卫生—骨科学]