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目的：评价口服硝酸盐类药物后静息９９ｍ Ｔｃ Ｍ Ｉ Ｂ Ｉ闪烁显像对慢性心肌梗塞病人的存活心肌和左心室功能改善情况的预测价值，应用９９ｍ Ｔｃ Ｍ Ｉ Ｂ Ｉ的平均摄取率定位心肌梗塞部位。方法：选有 Ｑ 波心肌梗塞且血管造影证实有冠状动脉疾病及通过左心室造影发现有运动减少、运动不能和随意障碍的病人 ４０ 例，这些病人均在首次闪烁显像研究之前有 ３ 个月以上的心梗病史，且均进行了冠状动脉再通术。于血管再通术前进行９９ｍ Ｔｃ Ｍ Ｉ Ｂ Ｉ Ｓ Ｐ Ｅ Ｃ Ｔ 显像，显像当天先口服长效硝酸甘油（平均剂量８５±３５ｍ ｇ）。以后又对其重新进行血管造影和心室功能测定，测定射血分数和前壁、后壁心肌梗塞中心区的９９ｍ Ｔｃ Ｍ Ｉ Ｂ Ｉ平均摄取率并进行统计学分析。闪烁显像阳性预测值和阴性预测值及诊断的准确性用标准公式计算。结果：在血管再通前，前壁心肌梗塞病人左室功能改善者（ｎ＝ ５）的梗塞中心区对９９ｍ Ｔｃ Ｍ Ｉ Ｂ Ｉ的平均摄取率（６８％ ±１２％ ）明显高于功能未改善者（４０％±１４％ ，ｎ＝ ８； Ｐ＜ ０．０２）；而下壁心肌梗塞病人左室功能改善者（ｎ＝ １４）的梗塞中心区的平均摄取率（４３％ ±７％ ）明显低于功能改善的前壁?
OBJECTIVE: To evaluate the predictive value of resting 99m Tc-M I B I scintigraphy on the improvement of myocardial viability and left ventricular function in patients with chronic myocardial infarction after oral administration of nitrates. The mean 99m Tc-M I B I uptake Rate the location of myocardial infarction. METHODS: Forty patients with Q-wave myocardial infarction who had coronary artery disease confirmed by angiography and left ventricular angiography were found to have reduced motion, insomnia, and atopic disorders, all of whom were 3 months prior to the first scintigraphy study Over the history of myocardial infarction, and have undergone coronary recanalization. 99m Tc-M I B I S P E C T imaging was performed before the recanalization. Long-acting nitroglycerin was orally administered on the day of imaging (mean dose 85 ± 35 m g). Later angiography and ventricular function were re-measured, measured ejection fraction and anterior wall, posterior wall myocardial infarction center 99m Tc M I B I average uptake rate and statistical analysis. The positive predictive value and negative predictive value of the scintigraphy and the diagnostic accuracy were calculated using standard formulas. RESULTS: The mean uptake of 99m Tc-M I B I in the infarct center of patients with anterior wall myocardial infarction (n = 5) was significantly higher than that of the functional (40% ± 14%, n = 8; P <0.02), while the mean infarct center area uptake in patients with inferior myocardial infarction (n = 14) was 43% ± 7 %) Is significantly lower than the functional improvement of the anterior wall?