论文部分内容阅读
通过动物模型验证系列心肌灌注显像判断急性缺血后再灌注心肌挽救的价值。将２４只狗模拟临床急性心肌缺血冠脉再通术后转归，分为缺血－有效心肌挽救（Ⅰ）组、缺血－延迟再通（Ⅱ）组和缺血－无再通（Ⅲ）组。所有动物接受缺血当时，灌注重建后即刻，之后７天、１４天及２８天系列９９ｍＴｃ－ＭＩＢＩ断层显像。在极座标靶心图上求出各次显像时心肌缺损分数（ＤＦ），并与病理证实心肌缺血分数（ＩＦ）、心肌梗塞分数（ＮＦ）对比。结果Ⅰ组从第２次显像起，ＤＦ持续下降；Ⅱ组ＤＦ下降程度小；Ⅲ组ＤＦ无降低。首次显像的ＤＦ与ＩＦ相关良好；末次显像ＤＦ与ＮＦ相关。再灌注后，即刻与再灌注前ＤＦ差在三组动物间有明显差别，并与每组动物的最后结果趋势一致。表明系列９９ｍＴｃ－ＭＩＢＩ显像可以准确、及时反映缺血－再灌注后心肌实际状态；缺血当时显像的ＤＦ显示缺血影响范围，而数周后显像ＤＦ反映坏死心肌大小；再灌注后即刻显像可提供准确、可靠的介入响应及预后的信息；冠脉介入前、后，及３—４周后显像的临床实用价值最为明确。
To evaluate the value of myocardial perfusion imaging in acute myocardial infarction after myocardial ischemia reperfusion. Twenty-four dogs were enrolled in this study and were randomly divided into ischemia-reperfusion (Ⅰ), ischemia-reperfusion (Ⅱ) and ischemia- Group Ⅲ). All animals received ischemia at that time, immediately after perfusion reconstruction, and serial 99m Tc-MIBI tomography at days 7, 14 and 28. Myocardial defect scores (DFs) at various imaging times were obtained from the polar constellation of bull’s eye and were compared with pathologically confirmed myocardial ischemic (IF) and myocardial infarction scores (NF). Results From the second imaging in group Ⅰ, DF continued to decrease; in group Ⅱ, DF decreased less; in group Ⅲ, DF did not decrease. For the first time, DF was correlated well with IF; final imaging was associated with NF. Immediately after reperfusion, there was a significant difference in DF difference between the three groups of animals immediately prior to reperfusion, consistent with the trend toward the final result for each group of animals. The results showed that serial 99mTc-MIBI imaging could accurately and timely reflect the actual state of myocardium after ischemia-reperfusion. DF in ischemic area showed the extent of ischemic area, and DF in several weeks showed the size of necrotic myocardium. Immediately after reperfusion, Like to provide accurate and reliable information on the intervention response and prognosis; the clinical value of imaging before, after, and after 3-4 weeks of coronary intervention is most clearly defined.