门控核素心肌灌注显像预测冠状动脉介入治疗疗效的价值  

Usefulness of electrocardiography-gated myocardial perfusion imaging for predicting effect of percutaneous coronary intervention

作　　者：程旭[1] 李殿富[2] 黄钢[3] 徐兆强[1] 陶如琦[4] 刘建军[3] 冯建林[1] 李建华[1] 

机构地区：[1]南京医科大学第一附属医院核医学科,南京210029 [2]南京医科大学第一附属医院心脏科,南京210029 [3]上海交通大学附属仁济医院核医学科 [4]上海交通大学附属仁济医院心脏科

出　　处：《临床心血管病杂志》2009年第12期905-908,共4页Journal of Clinical Cardiology

基　　金：江苏省卫生厅基金资助项目(No:H200509);上海市科委重点基金资助项目(No:034119823);上海市卫生局百人计划资助项目(No:97BR012)

摘　　要：目的:探讨99mTc-甲氧基异丁基异腈(MIBI)门控核素心肌灌注显像(G-MPI)在预测冠状动脉介入治疗(冠状动脉支架置入术)疗效方面的价值。方法:30例接受经皮冠状动脉支架置入术的冠心病患者均在支架置入术前1周及随访期内(5.67±3.23个月)完成两日法负荷/静息G-MPI,在支架置入术和随访核素心肌灌注显像之间无主要不良心脏事件的发生,比较术前及随访期的G-MPI定性和定量分析的结果。结果:G-MPI示支架置入术后缺血心肌节段数[(1.77±2.06)个]明显少于术前[(4.57±2.93)个](P=0.000),梗死心肌节段数则无显著差异(P=0.599)。支架术后总负荷评分和负荷静息评分差值较术前明显降低(P值分别为0.001和0.002)。支架置入术后,患者的LVEF由(56.43±16.59)%升高至(62.50±19.05)%(P=0.003),左室舒张末容积和左室收缩末容积均明显降低(P分别为0.005和0.000)。结论:术前行核素心肌显像判断缺血存活心肌的情况,可以对支架置入术的疗效进行较为准确的预测,门控采集所获得的心室功能和容积也有助于对患者进行危险度分层。Objective：To investigate the clinic value of using 99mTc MIBI gated myocardium perfusion imaging （G-MPI） to predict effect of percutaneous coronary intervention （stent implantation）. Method： Thirty patients of CAD with stent implantation underwent stress/rest 99mTc-MIBI G-MP1 before （1 week） and after （5.67±3.23 months） PCI procedure respectively and the results of C-MPI were compared. The patients had not severe adverse event within the following period after PCI. Result： The amount of segments of ischemic myocardium after PCI （1. 77±2.06） was less than those before PCI （4.57±2.93） significantly （P=0. 000） and the segments of infarct myocardium were similar （P=0. 599）. The values of SSS and SDS after PCI were lower than those before PCI sig nificantly （P=0. 001 and 0. 002 respectively）. After stent implantation, the value of LVEF was higher （P= 0. 003）,while the values of LVEDV and LVESV were lower rather than those before PCI （P=0. 005 and 0. 000 respectively）. Conclusion：G-MPI had good clinic value to predict the effect of PCI.

关 键 词：体层摄影术 发射型计算机 单光子 冠状动脉疾病 甲氧基异丁基异腈 

分 类 号：R817.4[医药卫生—影像医学与核医学]