^99Tc^m—MIBI静息门控心肌灌注显像在心肌梗死干细胞移植治疗中的价值  

The value of ^99Tc^m-MIBI rest gated myocardial perfusion imaging in patients with acute myocardial infarction treated by stem cell transplantation

作　　者：李凤岐[1] 李现军[1] 王健[2] 赵志华[1] 代学之[1] 刘世娟[1] 冯志徐[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院核医学科,261041 [2]潍坊医学院附属潍坊市人民医院心内一科,261041

出　　处：《中华核医学杂志》2009年第4期227-229,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的用^99Tc^m-甲氧基异丁基异腈（MIBI）静息门控心肌灌注显像的方法，评价急性心肌梗死（AMI）患者自体骨髓间质干细胞（MSC）移植术治疗的疗效。方法AMI患者31例，均行经皮冠状动脉介入治疗（PCI）术，其中18例患者作为试验组，于PCI术后行自体MSC移植术治疗，PCI术后拒绝行细胞移植治疗的13例患者作为对照组。于PCI术前，术后1，3和6个月进行^99Tc^m-MIBI静息门控心肌灌注断层显像，评价心肌血流灌注及心功能改善程度。统计学处理采用SPSS11．0软件，行t检验。结果所有患者术后1个月放射性稀疏节段数明显减少，术后3个月和6个月放射性缺损节段数试验组（2．37±1．09和2．21±0．93）较对照组（3．24±0．93和3．21±1．05）明显减少（t=2．32，2．79，P均〈0．05）；与术前[（35．4±16．7）％和（32．8±15．9）％]相比，术后6个月试验组[（57．2±14．3）％]和对照组[（44．8±11．7）％]患者左心室射血分数（LVEF）均显著升高（t=4．27，2．18，P均〈0．05），试验组患者LVEF明显高于对照组（t=2．58，P〈0．05）。结论心肌梗死患者自体MSC移植术后，应用^99Tc^m-MIBI静息门控心肌灌注显像随访和评价疗效有一定临床价值。Objective Myocardial cell regeneration therapy is one of the most researched topics in modem medical science. The objective of this study was to evaluate the clinical value of ^99Tc^m-methoxy- isobutylisonitrile （MIBI） rest gated myocardial perfusion imaging in patients with acute myocardial infarction （AMI） treated by stem cell transplantation. Methods Thirty-one patients with AMI were all treated by percutaneous coronary intervention （PCI）. And 18 of them subsequently had mesenchymal stem cell （MSC） transplantation therapy. All the patients were examined by ^99Tc^m-MIBI rest gated myocardial perfusion imaging at the time before and after PCI to evaluate the left ventricular myocardial perfusion and function. The t-test was used to compare data statistically with SPSS 11.0. Results The number of myocardial segments with perfusion abnormalities decreased in all the AMI patients 1 month after PCI. The number of myocardial segments with perfusion defects decreased 3 to 6 months after PCI in the patients treated by MSC transplantation （2.37±1.09 and 2.21 ± 0.93 ） when compared with the control group without MSC transplantation therapy （3.24 ± 0.93 and 3.21 ± 1.05, t = 2. 32, 2. 79, both P 〈 0.05 ）. The left ventricular ejection fraction （LVEF） of the patients treated by MSC transplantation increased 6 months after PCI compared with the control group [ （57.2 ±14.3 ） % and （44.8 ±11.7 ） %, respectively, t = 2. 58, P 〈 0. 05 ]. Conclnsion ^99Tc^m-MIBI rest gated myocardial perfusion imaging is an effective functional imaging to evaluate the therapeutic response in patients with AMI treated by MSC transplantation.

关 键 词：心肌梗塞 干细胞 移植 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]