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目的:探讨99mTc-甲氧基异丁基异腈(MIBI)门控核素心肌灌注显像(G-MPI)在预测冠状动脉介入治疗(冠状动脉支架置入术)疗效方面的价值。方法:30例接受经皮冠状动脉支架置入术的冠心病患者均在支架置入术前1周及随访期内(5.67±3.23个月)完成两日法负荷/静息G-MPI,在支架置入术和随访核素心肌灌注显像之间无主要不良心脏事件的发生,比较术前及随访期的G-MPI定性和定量分析的结果。结果:G-MPI示支架置入术后缺血心肌节段数[(1.77±2.06)个]明显少于术前[(4.57±2.93)个](P=0.000),梗死心肌节段数则无显著差异(P=0.599)。支架术后总负荷评分和负荷静息评分差值较术前明显降低(P值分别为0.001和0.002)。支架置入术后,患者的LVEF由(56.43±16.59)%升高至(62.50±19.05)%(P=0.003),左室舒张末容积和左室收缩末容积均明显降低(P分别为0.005和0.000)。结论:术前行核素心肌显像判断缺血存活心肌的情况,可以对支架置入术的疗效进行较为准确的预测,门控采集所获得的心室功能和容积也有助于对患者进行危险度分层。
Objective: To investigate the value of 99mTc-MIBI Gated Myocardial Perfusion Imaging (G-MPI) in predicting the therapeutic effect of coronary intervention (coronary stenting). Methods: Thirty patients with coronary heart disease who underwent percutaneous coronary stent implantation completed the two-day loading / resting G-MPI at 1 week before stent implantation and at the follow-up period (5.67 ± 3.23 months) There was no major adverse cardiac event between stenting and follow-up nuclide perfusion imaging, and the results of qualitative and quantitative G-MPI analysis before and during follow-up were compared. Results: Compared with preoperative [(4.57 ± 2.93)] (P = 0.000), the number of ischemic myocardial segments after stent implantation in G-MPI group was significantly lower than that in preoperative Differences (P = 0.599). The total postoperative stent load and resting resting load scores were significantly lower than those before surgery (P values were 0.001 and 0.002, respectively). After stent implantation, LVEF in patients increased from (56.43 ± 16.59)% to (62.50 ± 19.05)% (P = 0.003), and left ventricular end-diastolic volume and left ventricular end-systolic volume decreased significantly And 0.000). Conclusion: Preoperative radionuclide myocardial imaging to determine the survival of ischemic myocardium can be more accurate prediction of the efficacy of stenting, ventricular function and volume obtained by gated acquisition also contribute to the patient’s risk Layered.