缺血心肌99Tcm-MIBI清除率变化的临床研究  

Clinical investigation on the alteration of 99Tcm-MIBI washout rate in ischemic myocardium

作　　者：杜补林[1] 李娜[1] 李亚明[1] 尹雅芙[1] 李雪娜[1] 李德顺[1] 

机构地区：[1]中国医科大学附属第一医院核医学科,沈阳110001

出　　处：《中华核医学杂志》2010年第5期291-294,共4页Chinese Journal of Nuclear Medicine

基　　金：基金项目：辽宁省教育厅2008年高等学校科研项目（2008830）

摘　　要：目的 探讨缺血性心脏病（IHD）患者心肌99Tcm-甲氧基异丁基异腈（MIBI）早期、晚期清除率的变化及其评估缺血心肌细胞功能障碍的价值.方法 对临床诊断为IHD并满足冠状动脉三支主要分支狭窄均≥50%、除外心肌梗死的16例患者行99Tcm-MIBI静态平面及门控心肌灌注断层显像.用t检验比较99Tcm-MIBI早期（注药后90 min）、晚期（注药后4 h）清除率及左心室射血分数（LVEF）与健康对照组（10名）的差异,并对早期、晚期清除率与LVEF行直线相关分析.结果 IHD组早期、晚期心肌清除率及LVEF分别为（13.44±2.87）%、（19.24±4.71）%和（55.71±7.97）%,健康对照组分别为（17.32±4.92）%、（15.23±3.81）%和（67.75±5.43）%,2组相比差异均有统计学意义（t值分别为2.384,-2.246及-4.418,P均＜0.05）.早期及晚期清除率与LVEF不具有相关性,r值分别为-0.212（P＞0.05）及0.352（P＞0.05）.结论 IHD患者心肌99Tcm-MIBI清除率异常可反映缺血引起的细胞功能损伤.Objective To investigate the changes of early and delayed washout rates of 99Tcm-methoxyisobutylisonitrile （MIBI） in ischemic heart disease （IHD）, and to explore the value of 99Tcm-MIBI SPECT in evaluating impairment of ischemic myocardial cells. Methods Patients diagnosed of IHD with three-vessel stenosis （ ≥50% ） without myocardial infarction based on angiography （CAG） underwent 99Tcm-MIBI static planar and gated SPECT imaging. The early （90 min after the intravenous injection） and delayed （4 h after the intravenous injection） washout rates of 99Tcm-MIBI and left ventricular ejection fraction （LVEF） of IHD patients and normal subjects were compared using t-test. Linear correlation analysis was performed between the early, delayed washout rates and LVEF measured by gated SPECT. Results Statistically significant lower early washout rate of 99Tcm-MIBI was observed in IHD group than control group： （13.44 ± 2.87 ）%vs （ 17.32 ± 4.92） %, t = 2.384, P 〈 0.05, but higher delayed washout rate of 99Tcm-MIBI was observed in IHD group than control group： （19.24 ±4.71）% vs （15.23 ±3.81）%, t= -2.246, P〈0.05. LVEF in IHD group was significantly lower than that in control group： （55.71 ±7.97）% vs （67.75 ±5.43）%, t =-4.418, P 〈0.01. There were no correlations between the early/delayed washout rates and LVEF, respectively in IHD patients （r = -0.212, P 〉 0.05 r =0.352, P 〉 0.05, respectively）. Conclusion 99Tcm-MIBI washout rate may reflect myocardial cell impairment due to IHD.

关 键 词：心肌缺血 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]