摘要
目的利用SPECT心肌灌注显像观察川芎嗪对急性心肌梗死(AMI)急诊冠状动脉介入治疗(PCI)后患者心肌微循环的影响,以探讨“心肌无复流”治疗的新途径。方法行PCI的AMI患者82例,分为川芎嗪组(治疗组,40例)和对照组(42例)。受检患者分别于梗死相关血管(IRA)再通即刻、川芎嗪治疗24 h内及第15天分别注射^(99)Tc^m-tetrofosmin 555、1110和740 MBq,1 h后用SPECT行门控静息心肌灌注显像。用CEqual和QGspect软件分别处理,得到3个断面断层图像及左室射血分数(LVEF)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)。并分别计算心肌显像总积分。结果治疗组与对照组PCI后即刻LVEF(%)(47．5±7．1和48．4±8．6)、LVEDV (ml)(91．1±24．5和89．1±23．4)、LVESV(ml)(48．7±16．4和45．9±16．7)和心肌显像积分(7．8±2．9和7.5±3．1)差异无显著性(P＞0．05);PCI后24 h内,治疗组LVEF(%)(43．5±8．0)较对照组(44．7±8．3)减少更为明显(P＜0．05),而LVEDV(ml)(93．5±24．9和99．2±24．8)、LVESV(ml) (52．9±16．1和54．5±14．4)呈增加趋势,2组间差异无显著性(P＞0．05);PCI后15 d,治疗组与对照组比较,LVEF(%)(45．5±6．9和45．6±7．6)、LVEDV(ml)(92．8±24．9和99．9±22．3)及LVESV(ml)(51．2±17．0和54．8±16．1)均明显改善(P＜0．05)。治疗组与对照组PCI后24 h内及15 d心肌显像积分比较,治疗组积分减少更为明显(4．5±2．6,3．0±2．5和6．0±2．6,4．2±2．7;P＜0．05)。结论SPECT心肌灌注显像能准确反映川芎嗪对“心肌无复流”的改善。
Objective To evaluate the effect of Liqustrazine on myocardium microcirculation in patients with acute myocardial infarction after emergency percutaneous coronary intervention （PCI） by using SPECT imaging, and to explore new therapeutic methods for treatment of ＂myocardium no-reflow＂. Methotis Eighty-two patients after PCI were divided into Liqustrazine group （40 patients ） and control group （42 patients）. All patients were injected with 99Tcm-tetrofosmin （P53） immediately after revasculafization of the obstructed blood vessel, and repeated 24 h and 15 d after treatment with Liqustrazine. Rest gated myocardial imaging was performed 1 h after injection. Cequal and QGspect software was used for imaging processing. Also, left ventficular ejection fraction （ LVEF）, left ventricular end-systolic volume （LVESV） and left ventricular end-diastolic volume （ LVEDV ） were calculated . Finally, summed score of myocardial imaging （SSMI） was obtained. Results Immediately after PCI, there was no significant difference in LVEF [（47.5±7.1）% and （48.4±8.6）%1, LVEDV [（91.1±24.5） and （89. 1±23.4） ml], LVESV [（48.7 ± 16.4） and （45.9 ± 16. 7 ） ml]and SSMI （7.8 ± 2.9 and 7.5 ± 3.1 ） between two groups （ P 〉 0. 05 ）. Twentyfour hours after PCI, LVEF of Liqustrazine group decreased more distinctively than that of control group （P 〈 0. 05） ; but there was no significant deviation in LYEDV and LYESV between the two groups （P 〉0. 05）. Compared with control group, Liqustrazine group improved significantly in LVEF, LVEDV and LVESV 15 d after PCI （P〈0.05）. Finally, in 24 h and 15 d after PCI, SSMI of Liqustrazine group decreased more distinctively than that of control group （P 〈 0. 05）. Conclusion Myocardial perfusion imaging can accurately reflect the improvement of ＂myocardium no-reflow＂ after treatment with Liqustrazine.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2006年第6期366-369,共4页
Chinese Journal of Nuclear Medicine
关键词
心肌梗塞
冠状动脉介入治疗
川芎嗪
药物疗法
体层摄影术
发射型计算机
单光子
Myocardial infarction
Percutaneous coronary intervention
Liqustrazine
Drug therapy
Tomography, emission-computed, single-photon
作者简介
通信作者：杨军，Email：yangiqh@126．com
