99Tcm-MIBI心肌灌注断层显像评价通心络对急性心肌梗死后心肌无再流的影响  

Evaluation of the therapeutic effect of Tongxinluo for acute myocardial infarction using 99 Tcm.MIBISPECT imaging

作　　者：郭月红[1] 王铁[1] 

机构地区：[1]首都医科大学附属北京朝阳医院核医学科,100020

出　　处：《中华核医学与分子影像杂志》2012年第2期127-130,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的应用18Tcm一MIBIMPI评价通心络（超微粉剂）对AMI患者接受急诊PCI治疗后心肌无再流的效果。方法38例急诊人院AMI患者，按随机数字表法分为常规组18例和通心络组（常规治疗＋通心络）20例。2组患者均分别于急诊PCI治疗后7d及180d行18Tcm-MIBIMPI。将左室心肌分为17个节段，对心肌摄取18Tcm一MIBI的程度进行评分，分别统计2组第7天及第180天心肌稀疏缺损节段数及两者相减的节段数，并分别计算2组第7天和第180天心肌显像的总积分及两者相减的积分。使用SPSS11．5软件，对数据行t检验和矿检验。结果通心络组急诊PCI治疗后7dMPI稀疏缺损节段数共59个，180d时显像示改善的节段数为37个（62．7％，37／59）；常规组急诊PCI治疗后7dMPI稀疏缺损节段数共64个，180d时显像示改善的节段数为26个（40．6％，26／64）；2组改善节段数差异有统计学意义（X2=5．994，P〈0．05）。通心络组与常规组急诊PCI治疗后7d心肌显像的总积分分别为6．2±8．4和7．44-6．9（t=0．5，P〉0．05）；180d心肌显像的总积分分别为3．4±4．6和6．84-5．9（t=2．1，P〈0．05）；2组2次心肌显像总积分的差值（即患者心肌血流灌注改善情况的积分）分别为2．94-5．7和0．64-3．3（t=1．5，P〉O．05）。结论通心络（超微粉剂）能够缩小AMI再灌注治疗后心肌无再流面积，对心肌无再流现象有一定疗效。Objective To investigate the treatment effect of Tongxinluo for revasculatization im- provement after PCI using 99Tcm-MIBI SPECT imaging for AMI patients. Methods A total of 38 patients with AM/were randomly divided into a control group （PCI only, 18 patients ） and Tongxinluo treatment group （20 patients）. 99Tcm-MIBI myocardial SPECT was performed 7 d and 180 d after PCI. The left ven- trieular myocardium was divided into 17 segments. The myocardial 99Tcm-MIBI uptake was scored semi- quantitatively. The number and scores of abnormal perfusion segments were evaluated in all patients. T-test and x2 test were used to compare the difference between the two groups using SPSS 11.5. Results The to- tal number of abnormal segments in the treatment group was 59 at 7 d after PCI, among which 37 （62.7%, 37/59） had improved perfusion at 180 d after PCI. In the control group, 64 abnormal segments were found at 7 d after PCI; however, the perfusion was improved in only 26 （40.6% ,26/64） segments at 180 d after PCI. By comparing the myocardial perfusion defect scores, there was a significant difference （X2 = 5. 994, P 〈 0.05 ） between the control and treatment groups. The total scores of treatment and control groups were 6.2 ＋ 8.4 and 7.4 ＋ 6.9 （ t = 0.5, P 〉 0.05 ）, respectively, at 7 d after PCI and 3.4 ＋ 4.6 and 6.8 ＋ 5.9 （t=2.1, P〈0.05） , respectively, at 180 d after PCI. The changes in scores were 2.9 ~5.7 and 0.6 -＋ 3.3 （t = 1.5, P 〉0.05 ） in the treatment and control groups between 7 d and 180 d after PCI. Conclusion Tongxinluo can reduce the number of persistent perfusion defects after PCI treatment in patients with AMI,and thus has a potential role in preventing revascularization failure.

关 键 词：心肌梗塞 心肌再灌注 通心络 体层摄影术 发射型计算机 单光子 MIBI 

分 类 号：R542.22[医药卫生—心血管疾病]