SPECT心肌灌注显像评价激光心肌血管重建术  

Evaluation of the experimental transmyocardial laser revascularization with SPECT myocardial perfusion imaging

作　　者：胡硕[1] 梁昌华[1] 潘爱艮[1] 李景和[1] 沈明[1] 

机构地区：[1]湖南医科大学附属湘雅医院核医学科

出　　处：《中华核医学杂志》1999年第3期155-157,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的观察激光心肌血管重建术（ＴＭＬＲ）对实验性急性心肌梗死的近期效果。方法将１６只羊随机分为实验组和对照组，结扎冠状动脉左前降支（ＬＡＤ），建立急性心肌梗死模型。实验组于结扎后１ｈ用功率为６Ｗ的钬激光，在前壁缺血区打孔；对照组结扎后不打孔。结扎之后４ｈ行９９Ｔｃｍ甲氧基异丁基异腈（ＭＩＢＩ）ＳＰＥＣＴ心肌灌注显像，采用半定量法，计算左室心肌短轴、垂直长轴、水平长轴前壁感兴趣区内象素的平均计数与色标上限峰值之比Ｒ值。ＳＰＥＣＴ检查后取前壁缺血心肌组织行碱性磷酸酶（ＡＫＰ）染色，并测心肌线粒体锰超氧化物歧化酶（ＭｎＳＯＤ）活力。结果ＳＰＥＣＴ心肌灌注显像，实验组前壁心肌放射性分布稀疏，而对照组放射性分布缺损，短轴和垂直长轴上的Ｒ值实验组分别为０５７±０２１和０６０±０２９，对照组分别为０３０±００９和０３７±０１４，两组间Ｒ值的差异有显著性（Ｐ＜０．０２或Ｐ＜０．００２）。病理检查：实验组ＡＫＰ染色呈阳性，对照组呈阴性。实验组心肌线粒体的ＭｎＳＯＤ活力［（７０２２±１４６）ＮＵ／ｍＬ］较对照组［（６４７６±１６９）ＮＵ／ｍＬ］显著升高（Ｐ＜００１）。结论ＳＰＥＣＴ心肌灌注显像是?Objective To study the short term effects of experimental transmyocardial laser revascularization (TMLR) in acute myocardial infarction Methods Acute myocardial infarction was produced by ligating the left anterior descendening coronary artery in l6 goats, then randomly divided into control and TMLR group In TMLR group TMLR was performed with HolmiumYAG 1 h after ligation in anterior infarcted wall of the left ventricle.Myocardial perfusion imaging with 99 Tcmsestamibi SPECT was performed in both groups.Semiquantitative method was used for the calculation of R value (R=M i /3C).After imaging, ischemic myocardial tissue was taken for histochemical study of alkaline phosphatase (AKP) and determination of Mnsuperoxide dismutase (MnSOD) activity in myocardial mitochondria Results Myocardial perfusion SPECT imaging showed decreasing of radiodistribution in anterior wall of TMLR group but with radioactivity deficit area in lesioned tissue of control group.The R value of short axis and vertical long axis in TMLR group was 057021 and 060029, whereas 030009 and 037014 in control group respectively There was significant difference between these two groups ( P <002 or P <0002) Histochemical study demonstrated AKP staining positive in TMLR group, whereas negative in control group Activities of MnSOD in myocardium tissue in TMLR group increased significantly as compared with that of control group ( P <0001) Conclusions Myocardial perfusion with SPECT imaging is an effective method to evaluate the revascularization TMLR in acute myocardial infarction

关 键 词：心肌梗死 心肌血管重建术 TMLR SPECT 

分 类 号：R542.220.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]