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目的 :利用小剂量 Dob介入 99m Tc- MIBI(MB- Dob)和 2 0 1 Tl再注射显像 (Tl- PR)、小剂量 Dob介入 2 0 1 Tl再注射显像 (Tl- Dob)的对比研究 ,探讨小剂量 Dob介入对提高存活心肌检出率的作用。方法 :6 9例 OMI患者分二组在 14d内做了 Tl- PR、Tl- Dob在 7d内做了潘生丁负荷 99m Tc- MIBI显像、MB- Dob。Tl- Dob于 4h时静脉点滴Dob,从 5 μg/ kg· min- 1开始 ,5 m in后增至 10 μg/ kg· min- 1此时再注射 2 0 1 Tl40 MB并继续维持 5 m in;MB- Dob静脉点滴 Dob过程同 Tl- Dob,在 Dob浓度增至 10 μg/ kg· min- 1时 ,嘱患者舌下含服硝酸甘油 1mg,5 m in后静脉推注 99mTc- MIBI 740 MBq。结果 :MB- Dob心肌灌注明显改善节段率为 46 .7% ,Tl- PR为 32 .2 % ,Tl- Dob为 37.7% ,MB- Dob与 Tl- PR的心肌灌注明显改善节段数差异显著 ,与 Tl- Dob无显著差异 ,并且 MB- Dob与 Tl- PR心肌灌注明显改善节段的放射性摄取率增加值差异显著。结论 :MB- Dob较 Tl- PR可明显提高存活心肌的检出率 ,是一种安全、有效 ,易于推广的判断存活心肌的方法。
OBJECTIVE: To compare the effects of low-dose Dob on 99 Tc-MIBI (99m Tc-MIBI) and 201 Tl-PR and low dose Dob on Tl-Dob To investigate the role of low-dose Dob intervention in improving the detection rate of viable myocardium. Methods: Sixty-one OMI patients underwent Tl-PR in two groups within 14 days. Tl-Dob was given dipyridamole 99m Tc-MIBI imaging and MB-Dob within 7 days. Dob was intravenously administered to Tl-Dob at 4 h, starting at 5 μg / kg · min-1 and then increasing to 10 μg / kg · min-1 after 5 m in. At this point, 210 μl of T 140 MB was injected and maintained for 5 min ; MB-Dob intravenous drip Dob process with Tl-Dob, Dob concentration increased to 10μg / kg · min-1, Zhu Huanzhe sublingual nitroglycerin 1mg, 5min after intravenous injection of 99mTc-MIBI 740MBq . Results: Myocardial perfusion with MB-Dob significantly improved the segment rate was 46.7%, Tl-PR was 32.2%, Tl-Dob was 37.7%, MB-Dob and Tl-PR myocardial perfusion significantly improved the number of segments was significantly different , There was no significant difference with Tl-Dob, and MB-Dob and Tl-PR myocardial perfusion significantly improved the segment of the radioactive uptake rate difference significantly. Conclusion: Compared with Tl-PR, MB-Dob can significantly improve the detection rate of viable myocardium, which is a safe, effective and easy-to-extend method for judging viable myocardium.