论文部分内容阅读
目的：通过心肌灌注断层显像研究急性心肌梗死（ＡＭＩ）患者经尿激酶及经皮冠状动脉腔内成形术（ＰＴＣＡ）治疗前后梗死范围的变化。方法：用９９ｍ锝甲氧基异丁基异腈心肌灌注断层显像测定３６例ＡＭＩ患者心肌再灌注前后的心肌梗死面积。结果：再灌注组和无再灌注组首次心肌显像心肌缺损面积无显著性差异（Ｐ＞０．０５）；再灌注组再次显像心肌缺损面积明显小于首次显像（１７．５±２．８％和３１．９±４．５％，Ｐ＜０．０５）；无再灌注组再次显像心肌缺损面积与首次显像无明显差异（２９．６±４．７％和３２．４±５．１％，Ｐ＞０．０５）；预后不良组（ｎ＝６）心肌缺损面积明显高于预后较好组（３４．６±５．１％和２１．４±３．６％，Ｐ＜０．０５）。结论：心肌灌注断层显像可作为ＡＭＩ再灌注疗效评价较准确的手段。
Objective: To investigate the changes of infarct size in patients with acute myocardial infarction (AMI) treated with urokinase and percutaneous transluminal coronary angioplasty (PTCA) by myocardial perfusion tomography. Methods: Myocardial infarct size was measured before and after myocardial reperfusion in 36 AMI patients with 99m Tc methoxyisobutyl isonitrile myocardial perfusion tomography. Results: There was no significant difference in myocardial defect area between the reperfusion group and the non-reperfusion group (P> 0.05). The area of myocardial defect after reperfusion was significantly lower than that of the first imaging (17.5 ± 2). 8% and 31.9 ± 4.5%, P <0.05). There was no significant difference in the area of myocardial defect between the two groups (29.6 ± 4.7% vs 32.4 ± 5.1%, P> 0.05). The area of myocardial defect in the poor prognosis group (n = 6) was significantly higher than that in the good prognosis group (34.6 ± 5.1% and 21.4 ± 3.6%, P <0.05). Conclusion: Myocardial perfusion tomography can be used as a more accurate evaluation of the efficacy of AMI reperfusion.