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用~(99m)锝焦磷酸盐进行心肌梗塞闪烁摄影是一项有价值的急性心肌梗塞辅助诊断方法。然而关于此法检测急性不可逆性心肌损伤的特异性,一直尚有争论。某些临床研究提示心肌摄取~(99m)锝焦磷酸盐可见于单纯心肌缺血,尤其在不稳定性心绞痛病人,闪烁摄取的假阳性多达42％。然而,这些研究中,急性心肌梗塞系按常规诊断标准(即心电图及血浆酶改变),并未采用高敏感方法多次测定血浆肌酸激酶(CK)及MB同功酶(MBCK)活性,因而不能检出血浆酶活性仅轻度暂时升高的急性心肌坏死病人。为了确定不稳定性心绞痛的~(99m)锝焦磷酸盐显象异常是否与小面积急性心肌坏死有关,作者对不稳定性心绞痛病人进行闪烁摄影检查,并多次测定血浆CK及MBCK 方法:临床诊断为不稳定性心绞痛病人166例,心电图均无新Q波,35例过去有心肌梗塞史。无1例伴有使~(99m)锝焦磷酸盐显象发生假阳性的疾病,如胸部创伤、肺肿瘤、最近电击转复、瓣膜钙化、室壁
Myocardial infarction scintigraphy with ~ (99m) technetium pyrophosphate is a valuable adjunct to the diagnosis of acute myocardial infarction. However, the specificity of this method for the detection of acute irreversible myocardial injury has been debated. Some clinical studies suggest that myocardial uptake of 99mTc-phenylpyrophosphate can be seen in isolated myocardial ischemia, especially in patients with unstable angina, with as much as 42% false-positive staining. However, in these studies, acute myocardial infarction did not measure plasma creatine kinase (MB) and MB isozyme (MBCK) activity multiple times by conventional diagnostic criteria (ie ECG and plasma enzyme changes) Can not be detected in plasma enzyme activity is only mild temporary increase in patients with acute myocardial necrosis. To determine if abnormalities in 99mTc-phenylpyrophosphate imaging in unstable angina are associated with small area acute myocardial necrosis, we performed a blinking photographic examination of patients with unstable angina and determined plasma CK and MBCK multiple times: clinical 166 cases of unstable angina were diagnosed, no new Q wave was detected in ECG, and 35 cases had a history of myocardial infarction in the past. None of the patients had a disease associated with false-positive imaging of 99m-technecid pyrophosphate, such as chest trauma, lung tumors, recent shock-to-electric shock, valvular calcification, ventricular wall