心肌缺血后心肌葡萄糖代谢异常延迟恢复的临床研究  

Clinical Research of the Increasing Ischemic Myocardial ^(18)F-FDG Uptake After Exercise-induced Myocardial Ischemia

作　　者：李佳[1] 窦克非[1,2] 杨敏福[1,2] 何祚祥[3] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院冠心病诊治中心,北京市100037 [2]首都医科大学附属朝阳医院核医学科,北京市100020 [3]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院核医学中心,北京市100037

出　　处：《中国分子心脏病学杂志》2015年第1期1185-1188,共4页Molecular Cardiology of China

基　　金：首都医学发展科研基金(2014-2-4033);首都特色临床应用研究基金(Z131107002213182)

摘　　要：目的探讨运动负荷诱发心肌缺血24小时后,缺血心肌对18F-FDG的摄取情况。方法 24例疑诊为冠心病的患者行运动负荷99mTcMIBI心肌灌注显像和18F-FDG心肌代谢显像,并在运动结束24小时后再次注射18F-FDG行静息心肌代谢显像。所有患者在显像1周内行冠状动脉造影检查。结果 24例患者中,冠状动脉造影显示20例患者有至少一条冠脉出现≥50%的管腔狭窄。在运动心肌显像中,15例患者(83%)有心肌18F-FDG摄取增加,其中11例患者(61%)有99mTc-MIBI灌注缺损;在运动结束24小时后的静息心肌代谢显像中,15例运动心肌显像中有18F-FDG摄取增加的患者中7例(46%)仍有18F-FDG摄取。结论运动试验诱发的心肌缺血可以导致心肌18F-FDG摄取的异常增加;在部分患者,18F-FDG摄取的增加可以持续到心肌缺血后的24小时。Objective To explore whether the increasing ischemic myocardial ^18F-FDG uptake can persist for24h or more long time after 24 hours of exercise-induced myocardial ischemia. Methods 24 patients with strong clinical suggestion of CAD underwent exercise 99mTc-sestamibi myocardial perfusion imaging and ^18F-FDG metabolism imaging.24 hours after the episode of exercise, the patients were reinjected ^18F-FDG and underwent ^18F-FDG imaging at rest. All patients underwent coronary angiograph within 1 week. Results Coronary angiograph showed that 20 patients had greater than or equal to 50% luminal narrowing in at least one coronary vessels. On the exercise ^18F-FDG imaging, 15（83% ） patients showed increased regional ^18F-FDG uptake, but only 11 patients （61% ） showed perfusion abnormalities on 99mTc-sestamibi imaging. On the rest ^18F-FDG imaging after 24 hours of the exercising,7 patients（46% ） of the 15 patients who showed increased regional ^18F-FDG uptake on exercise imaging showed persistent ^18F-FDG uptake. Conclusion myocardial ischemia by exercise can increase myocardial ischemia ^18F-FDG uptake. In some patients, the increasing of myocardial ischemia ^18F-FDG uptake can be persisted to 24 hours after ischemia.

关 键 词：心肌缺血 运动试验 ^18F-FDG 缺血记忆 

分 类 号：R542.2[医药卫生—心血管疾病]