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目的评价硝酸甘油（ＮＴＧ）介入下９９ｍＴｃ甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像在检测心肌梗死（心梗）后存活心肌中的价值。方法４８例Ｑ波型心梗病人行常规９９ｍＴｃＭＩＢＩ心肌显像（Ｒ），２４ｈ后静注示踪剂前５ｍｉｎ舌下含服ＮＴＧ（１．０ｍｇ），再行心肌显像（Ｎ），其中１２例病人作经皮腔内冠状动脉成形术（ＰＴＣＡ），术后１个月内行常规静息９９ｍＴｃＭＩＢＩ心肌显像（Ｐ）。结果Ｒ显像中１９３个灌注缺损节段，ＮＴＧ介入后有２８个节段恢复正常，２６个节段明显改善，１９个节段部分改善（Ｐ＜０．０５）。１２例行ＰＴＣＡ者术前ＮＴＧ介入后，灌注缺损得到改善的２１个节段中，术后有１６个节段得到改善，阳性预测率７６．２％，术前Ｎ显像无改善的５２个节段中，术后４２个节段无改善，阴性预测率８０．８％。结论ＮＴＧ介入后可提高９９ｍＴｃＭＩＢＩ心肌断层显像对存活心肌的检出，方便易行，安全可靠。
Objective To evaluate the value of 99mTc methoxycinnamic acid (MIBI) myocardial perfusion imaging in detecting viable myocardium after myocardial infarction (MI) with NTG intervention. Methods Forty-eight patients with Q wave myocardial infarction underwent routine 99mTcMIBI myocardial imaging (R). After 24 hours of intravenous injection of tracers, NTG (1.0 mg) was given sublingually and then myocardial imaging (N) was performed. Twelve The patients underwent percutaneous transluminal coronary angioplasty (PTCA), and the routine resting 99mTcMIBI myocardial imaging (P) was performed within 1 month after operation. Results 193 cases of perfusion defect in R imaging showed that 28 segments returned to normal after NTG intervention, 26 segments improved significantly and 19 segments improved partially (P <0.05). Of the 21 patients with PTCA who underwent preoperative NTG intervention, there were 16 segments with improved perfusion defect, 16 segments were improved after operation, the positive predictive rate was 76.2%, and there were 52 without preoperative N imaging In the segment, there was no improvement in 42 segments after operation, the negative predictive rate was 80.8%. Conclusion NTG intervention can improve 99mTcMIBI myocardial tomography detection of viable myocardium, convenient, safe and reliable.