^(99m)Tc-MIBI双嘧达莫负荷显像评估心肌细胞损伤和再灌注后的可修复性  

Assessment of the injury and repair of cardiac myocyctes after reperfusion with stress ^(99m)Tc-MIBI dipyridamole myocardial imaging

作　　者：陈宪英[1] 张国旭[1] 王治国[1] 贾迎[1] 王影[1] 张彤[1] 

机构地区：[1]解放军沈阳军区总医院核医学科,辽宁省沈阳市110016

出　　处：《中国临床康复》2003年第18期2520-2521,F003,共3页Chinese Journal of Clinical Rehabilitation

基　　金：辽宁省自然科学基金资助项目(98104004023)~~

摘　　要：目的研究犬陈旧性心肌梗死(陈旧心梗)损伤区心肌细胞损伤与修复的形态学变化与99mTc-MIBI摄取量的关系。方法选择犬12只,建立陈旧心梗模型,5个月后取心脏,通过透射电镜(TEM)观察99mTc-MIBI硝酸甘油介入和双嘧达莫负荷心肌显像缺损区和可逆性缺损区内心肌细胞的超微结构。结果硝酸甘油介入99mTc-MIBI放射性分布缺损区无完整的心肌细胞;99mTc-MIBI双嘧达莫负荷心肌显像可逆性缺损区,主要为低血流灌注的心肌细胞,心肌细胞部分线粒体肿胀、变形严重,基质密度下降、有灶状空化,线粒体空泡散在分布、少数连续分布,膜和嵴不完整;部分线粒体轻度变形,基质密度降低程度较轻,有点状空化,嵴排列不整齐或部分凋落。在近正常心肌一侧,多数心肌细胞的线粒体近似卵圆形,线粒体膜基本完整,基质密度轻度降低,嵴排列较整齐,偶见损伤较严重的线粒体。结论99mTc-MIBI的心肌摄取量与细胞损伤的程度有关;在99mTc-MIBI心肌显像可逆性缺损区,血流灌注改善后,大部分损伤的心肌细胞有修复的可能性。Aim To study the relationship of 99mTc-MIBI uptake to the morphology o f injury and repair of cardiac myocytes in the injured area of old myocardial in farction (OMI) in dogs. Methods Twelve dogs were divided into 2 groups of 6 dogs to undergo ligation of left anterior descending coronary artery (LAD) by 85%or 95%respectively so as to create OMI models. Five months after, dipyridamole an d 99mTc-MIBI were injected intravenously so as to obtain myocardial tomography. One day after, nitroglycerin was given sublingually and then 99mTc-MIBI of the same dose was injected intravenously to obtain nitroglycerin intervention myoca rdial tomography. The reversible defect area, necrosis area, and normal area wer e identified by comparison of the stress dipyridamole myocardial imaging and the nitroglycerin intervention myocardial imaging. Then the dogs were killed and th eir hearts were taken out to observe the cardiac myocyte ultrastructure of the d ifferent area by transmission electron microscope (TEM). Results The stress 99mT c-MIBI dipyridamole myocardial imaging and the nitroglycerin intervention 99mTc entricular ejection fraction (LVEF) in chronic heart failure (HF) patients.Metho ter the blood flow is improved, the majority of injured cardiac myocytes may be repaired in the reversible defect area by using stress 99mTc-MIBI-dipyridamole myocardial imaging.

关 键 词：^99MTC-MIBI 双嘧达莫 心肌细胞损伤 再灌注损伤 可修复性 陈旧性心肌梗死 硝酸甘油 放射性核素显像 

分 类 号：R542.22[医药卫生—心血管疾病] R816.2[医药卫生—内科学]