摘要
目的探讨门控心肌断层显像评价血运重建术(PTCA或CABG)对心肌梗塞患者左室重构及心功能影响的临床价值。方法心肌梗塞组(MI组)24例分别于PTCA或CABG术前1周和术后2～3月行静息门控心肌断层显像。正常对照组21例行静息门控心肌断层显像。利用机器程序分别算出左室舒张末期容积(EDV)、左室收缩末期容积(ESV)、左室射血分数(LVEF)、左室梗塞面积(IS)、左室球化指数(LVSI)。结果①MI组术前EDV、ESV和SI分别为(118.6±36.7)ml、(63.2±28.4)ml和1.00±0.12,显著高于对照组的(86.8±15.3)ml、(33.5±10.2)ml和0.80±0.06(P<0.01);MI组LVEF为(42.5±12.1)%,显著低于对照组(63.2±8.6)%。②MI组术后EDV、ESV、SI和梗塞面积分别为:(102.0±27.2)ml、(53.5±22.1)ml、0.91±0.08和(25.3±8.6)%,低于术前的(118.6±36.7)ml、(63.2±28.4)ml、1.00±0.12和(36.3±10.2)%(P<0.05);术后LVEF为(51.8±10.6)%,高于术前(42.5±12.1)%(P<0.01)。结论 MI患者存在不同程度的左室扩大、球型化等左室重构和心功能损害;血运重建术能挽救存活心肌、减低MI患者左室重构和改善心功能;门控心肌断层显像的多项指标对评价MI患者血运重建术的疗效有较高的临床价值。
Objective To evaluate the clinical value of gate myocardial perfusion imaging on left ventricular remodeling and heart function for the patients with myocardial infarction who underwent the revascularization（ PTCA or CABG）. Methods Rest- ing G-MPI with 99TcZ-MIBI were preformed before or after operation in 24 patients with MI who underwent revascularization（ PT- CA or CABG）. Additional 21 normal controls underwent the resting gate myocardial perfusion imaging. Left ventricular end-dias- tolic volume （ EDV ）, end-systolicvolume （ ESV ）, and ejection fraction （ LVEF ）, infarct size （ IS）, left ventricular sphere index （ LV- SI） obtained and analyzed. Results （1）The EDV, ESV and SI of MI group before PTCA or CABG were （ 118.6 ±36.7 ） mi, （63.2 ± 28.4）ml and 1.00 ±0. 12 respectively,which were significantly higher than those of the control group （86.8±15.3 ） ml, （33.5 ± 10.2） ml and 0.80 ± 0.06 （ P 〈 0.01 ）, there was significant difference between the two groups; The LVEF of MI group was （42.5± 12.1 ） %, which was significantly lower than that of the control group （ 63.2 ± 8.6 ） %, P 〈 0.01 ）. （1）The EDV,ESV and SI of MI group after FFCA or CABG were （ 102.0 ±27.2） ml, （53.5± 22.1 ） ml,0.91 ±0. 08 and （25.3 ±8.6 ） %, respectively which were significantly lower than those of before PTCA or CABG （ 118.6 ± 36.7 ） rrd, （ 63.2± 28.4 ） ml, 1.00 ± 0.12 and （36.3 ±10.2 ）% （P 〈0. 05 ）, the LVEF of after PTCA or CABG was （51.8±10.6 ） %, which was significantly higher than that of before PTCA or CABG （42.5± 12.1 ） % （ P 〈 0.01 ）. Condusion Myocardial infarction patients experience different degrees of left ventrieular enlargement, global dilatation, left ventricular remodeling, and cardiac function damage, PTCA or CABG could improve the situation respectively. Gate myocardial perfusion imaging was a useful technique for evaluating left ventricular remodeling and heart function following revascular
出处
《中华全科医学》
2012年第12期1841-1842,共2页
Chinese Journal of General Practice
基金
江苏省徐州市卫生局医学科研课题项目(XWJ2011048)
徐州市科技局社会发展项目(XM12B035)
关键词
门控心肌断层显像
心肌梗塞
血运重建术
Gated myocardial perfusion imaging
Myocardial infarction
Revascularization
