硝酸异山梨酯改善冠心病缺血区域血流量的临床研究  

Isosorbide Dinitrate Improving Myocardial Blood Flow of Ischemic Area in Patients with Coronary Heart Disease

作　　者：孟繁波[1] 杨平[1] 徐文贵[2] 赵林阳[1] 张木兰[1] 

机构地区：[1]白求恩医科大学中日联谊医院心内科,吉林省长春市130021 [2]白求恩医科大学中日联谊医院核医学科,吉林省长春市130021

出　　处：《中国循环杂志》1999年第6期335-337,共3页Chinese Circulation Journal

基　　金：吉林卫生厅 1 996年青年基金!(960 75)

摘　　要：目的 :临床上应用一种较客观简单方法评价硝酸异山梨酯改善冠心病缺血区域血流量的作用。　　方法 :采用99m锝 -甲氧基异丁基异腈 (99m Tc- MIBI)灌注断层显像展开图法评价药物治疗前后缺血心肌的面积变化 ,以面积变化来反应缺血区域血流量的变化。　　结果 :阈值 6 5 % :治疗前缺血心肌面积 6 1± 4cm2 ,占整个左心室面积的 (32± 6 ) % ,治疗后缺血心肌面积 5 3± 7cm2 ,占左心室面积的 (2 6± 7) % ;阈值 5 5 % :治疗前缺血面积 32± 6 cm2 ,占整个左心室面积的 (17± 6 ) % ,治疗后缺血心肌面积 2 9± 3cm2 ,占左心室面积的 (15± 3) %。核素面积的改变与心绞痛和缺血 ST- T的变化相一致。　　结论 :硝酸异山梨酯可以改善冠心病病人缺血区域血流量 ;灌注断层显像展开图是评价其作用的可行方法。Objective:We use an objective method to evaluate the effect of isosorbide dinitrate on myocardial blood flow of ischemic area. Method:We compare the ischemic area of heart before and after isosorbide is administrated by the method of 99m Tc methoxy isobutylisonitrile(MIBI) myocardial perfusion imaging unfold map.The variation of ischemic area is regarded as the variation of blood flow. Results:Sixty five percent threshold value,before treated,perfusion defect area 61±4 cm 2,perfusion defect area/whole left ventricular area(32±6)%.After treated,perfusion defect area 53±7 cm 2,defect area/the whole left ventricular area (26±7)%.55% threshhold value:before treated,perfusion defect area 32±6 cm 2,defect area/whole left ventricular area(17±6)%.After treated,perfusion defect area 29±3 cm 2,defect area/the whole left ventricular area (15±3)%.The variations of radionuclide myocardial perfusion imaging unfold map are no difference with the variation of electrocardiogram and angina pectoris. Conclusion:Isosorbide may improve the blood flow of iskemic area.Radionuclide myocardial perfusion imaging unfold map is a objective,practisable method of evaluating the effect of isosorbide.

关 键 词：冠心病 硝酸异山梨酯 血流量 临床研究 

分 类 号：R541.4[医药卫生—心血管疾病]