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目的评价静脉注射硝酸甘油(NTG)介入~(99m)锝-甲氧基异丁基异腈(~(99m)Tc-MIBI)心肌断层显像估测心肌梗死患者存活心肌的价值。方法 36例患者匀行静态心肌SPECT显像和NTG静脉注射介入心肌SPECT显像。36例心肌梗死患者的324个节段中,静态心肌显像共有130个节段(40.1%)灌注异常,静脉滴注硝酸甘油后心肌显像共有47个灌注异常节段得到改善,占总异常节段数的36.1%。结果 22例心肌灌注有改善(61.1%),14例未改善(38.9%)。22例有改善的患者介入前记分为(8.57±4.32)分(2～19分),介入后为(6.02±4.46)分(0～17分),介入前后记分有非常显著性差异(P<0.01)。未改善的14例介入前后记分值无变化。结论硝酸甘油介入试验确可提高静息~(99m)Tc-MIBI心肌断层显像对存活心肌的检测率。
Objective To evaluate the value of intravenous injection of ~ (99m) Tc-99m Tc-MIBI myocardial perfusion imaging with NTG in the assessment of viable myocardium in patients with myocardial infarction. Methods Thirty-six patients underwent static myocardial SPECT imaging and NTG intravenous injection on myocardial SPECT imaging. There were 130 segments (40.1%) perfusion abnormalities in static myocardial imaging in 324 segments of 36 patients with myocardial infarction. A total of 47 perfusion abnormalities in myocardial imaging were improved after intravenous nitroglycerin administration, accounting for the total abnormalities 36.1% of the number of segments. Results 22 cases of myocardial perfusion improved (61.1%), 14 cases did not improve (38.9%). Before intervention, the scores of patients with improvement in 22 cases were (8.57 ± 4.32) points (range, 2 to 19 points), and (6.02 ± 4.46) points (0 to 17 points) after intervention. There was a significant difference in scores before and after intervention (P < 0.01). The scores of uncorrected 14 patients before and after intervention did not change. Conclusion Nitroglycerin intervention test can indeed improve the detection rate of viable myocardium in resting ~ (99m) Tc-MIBI myocardial perfusion imaging.