・论著・广西壮族自治区卫生厅2007年科研计划立项课题组成部分(课题编号:Z2007186利用腺苷负荷门控心肌显像的心功能参数指标评价陈旧性心肌梗死患者的心功能付巍1a,范岩2,刘雪梅1b,陈征宇1b,谢卫华1b,刘韬1a,董庆华1a,1a(1.桂林市中西医结合医院a.核医学科,b.心内科,广西桂林541004;2.,摘要:目的后的价值。方法OMI组16例,正常对照组18例,(99Tcm2MIBI腺苷负荷门控灌注显像,(LV、、收缩末期容积(ESV及左室壁运动情况。结果OMI%(76.44±11.68%,而左室容积参数EDV明显大于正常对照组±(21ml和ESV(73.97±83.15mlvs(17.17±11.36ml;三维心室9(56.%患者出现室壁运动减弱;两组间心功能参数经统计学分析差异均有统计学意义(均P<0.05腺苷负荷门控心肌灌注显像中测得的功能参数是评价左室功能的重要指标,其对陈旧性心肌梗死患者的心功能评价、疗效观察及预后判定均有重要意义。关键词:心肌梗塞;99m锝甲氧基异丁基异腈;放射性核素显像;腺苷:R542.22文献标识码:A:10042583X(20072221614203HeartfunctionofpatientswitholdmyocardialinfarctionusingheartfunctionparametersobtainedwithgatedadenosinemyocardialperfusionSPECTFUWei3,FANYan,LIUXue2mei,CHENGZheng2yu,XIEWei2hua,LIUTao,DONGQing2hua,QINLi2hong3DepartmentofNuclearMedicine,GuilinChineseandWesternMedicineCombinationHospital,Guilin541004,ChinaABSTRACT:ObjectiveToexplorethevalueofheartfunctionparametersobtainedwithgatedadenosinemyocardialperfusionSPECTinassessingtheheartfunctionandprognosisofpatientswitholdmyocardialinfarction(OMI.MethodsAllthesubjectsintwogroups(16patientsinOMIgroupand18casesincontrolgroupunderwent99Tcm2MIBIgatedadenosinemyocardialperfusionsinglephotonemissioncomputedtomography(SPECT.Theparametersofend2diastolicvolume(EDV,end2systolicvolume(ESV,leftventricularejectfraction(LVEFwerecalculatedandthemotionofleftventricularwallwasobserved.Theparametersbetweentwogroupswerecompared.ResultsLVEFofOMIgroupwaslowerthanthatofcontrolgroup(57.00±23.42%vs(76.44±11.68%.Otherwise,theparametersofEDVandESVofOMIgroupwerehigherthanthoseofthecontrol(133.00±87.96mlvs(67.11±19.21mland(73.97±83.15mlvs(17.17±11.36ml.Three2dimensionalimagesofventricularcampaignofleftventricularwallwasfoundmovementlowerin9patientswithOMI(56.3%.Thedifferencesofcardiacfunctionparametersbetweentwogroupsweresignificant(P<0.05.ConclusionTheheartfunctionparametersobtainedwithgatedadenosinemyocardialperfusionSPECTarevaluableforleftventricularfunction.TheyhavehighsignificanceinassessingtheprognosisandthetherapyeffectofOMIpatients.KEYWORDS:myocardialinfarction;technetiumTc99msestamibi;radionuclideimaging;adenosine冠心病患者发生心肌梗死后,心肌供血发生严重障碍的同时心功能也常受到损伤。腺苷负荷核素心肌显像有助于了解心肌缺血区的情况,可用于冠心病的诊断及对其预后的评价。门控心肌显像是一种评价心功能状况的方法,采用腺苷负荷心肌灌注显像的方法在获得心肌供血情况的同时,还能得到多种心功能参数,由此能更全面地了解患者的心脏状况。本研究的目的是初步探讨腺苷负荷门控灌注显像在评价陈旧性心肌梗死(DMI患者心功能方面的应用价值。1对象与方法1.1研究对象OMI组16例,男11例,女5例,年龄42~83岁,平均(69.9±11.5岁,均符合WHO冠心病诊断标准,通过心电图、心肌灌注显像、冠状动脉造影及血液相关检查确诊为OMI。正常对照组18例,男10例,女8例,年龄33~87岁,平均(63.0±・4161・13.1岁,均按照WHO冠心病诊断标准除外冠心病,心电图、心肌灌注显像、冠状动脉造影等检查均正常。两组患者均无房颤等心律失常并发症。排除标准:严重高血压[即收缩压>180mmHg(1mmHg=0.133kPa和(或舒张压>100mmHg],急性冠状动脉综合征,严重心功能不全,病态窦房结综合征,~ⅡⅢ度房室传导阻滞(AVB,严重室性心律失常,支气管哮喘,先天性心脏病,心脏瓣膜病,心肌...