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为探讨尿毒症心肌病患者核素心肌显像特点及其临床应用价值,采用~(99m)Tc-甲氧基异丁基异腈(~(99m)Tc-MIBI)对30例正常对照者(对照组)和28例有明确的尿毒症病史伴心室扩大、充血性心力衰竭而确诊为尿毒症心肌病患者(尿毒症组)行静息心肌血流灌注断层显像。分析重建后的断层图像,计算并比较对照组和尿毒症组的左心腔/心肌计数比值(CMR)和肺/心计数比值(LHR)。结果显示,28例尿毒症心肌病患者均有不同程度左心室扩大,11例伴右心室扩大;左心室放射性分布基本均匀的有3例;呈花斑样改变的有10例;呈节段性稀疏或缺损的有15例,且为多节段心肌受损,受累心肌节段以后壁最多(93.3％),其次为下壁(66.6％)和前壁(60％)。尿毒症组LHR(0.33±0.05)高于对照组(0.29±0.04),P<0.01;而CMR(0.20±0.12)明显低于对照组(0.42±0.09),P<0.001。提示核素心肌显像可同时提供尿毒症心肌病心肌受损及左心功能障碍状况。
To investigate the characteristics of radionuclide myocardial imaging and its clinical value in patients with uremic cardiomyopathy, the effects of ~ (99m) Tc-methoxyisobutylisonitrile (~ (99m) Tc-MIBI) ) And 28 patients with definite history of uremia with ventricular enlargement and congestive heart failure were diagnosed as uremic cardiomyopathy (uremic group) underwent resting myocardial perfusion tomography. The reconstructed tomographic images were analyzed and the left ventricular / myocardial ratio (CMR) and lung / heart ratio (LHR) values were calculated and compared between the control and uremic groups. The results showed that 28 patients with uremic cardiomyopathy have varying degrees of left ventricular enlargement, 11 cases with right ventricular enlargement; left ventricular distribution was basically uniform in 3 cases; showed a spot-like changes in 10 cases were segmental Sparse or defect in 15 cases, and multi-segment myocardial damage, involved the myocardial segment after the wall (93.3%), followed by the inferior wall (66.6%) and the anterior wall (60%). LHR in uremia group was significantly higher than that in control group (0.29 ± 0.04), P <0.01; CMR (0.20 ± 0.12) was significantly lower than that in control group (0.42 ± 0.09), P <0.001. Tip nuclide myocardial imaging can provide both uremic cardiomyopathy myocardial damage and left ventricular dysfunction.