心肌显像评价存活心肌对维吾尔族心肌梗死患者PCI术指导的临床价值

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摘要目的：探讨氟代脱氧葡萄糖（18F-FDG）心肌代谢显像联合99m锝-甲氧异腈（99mTc-MIBI）心肌灌注显像对心肌存活评估的价值，通过此项显像来判定维吾尔族心肌梗死患者心梗区的坏死心肌及存活心肌，从而判断经皮冠状动脉介入术（PCI）术后存活心肌对维吾尔族心肌梗死患者心功能的影响。方法：78例确诊为心肌梗死的维吾尔族患者，其中男40例，女38例，年龄45～72岁，平均（51±14）岁，所有患者由冠脉造影证实至少有一支以上冠状动脉闭塞，患者均在PCI术前行99mTc-MIBI心肌灌注显像及18F-FDG心肌代谢显像，并根据显像结果，将患者分为心肌存活组与无心肌存活组。分别比较术前及术后2组患者的左室射血分数（LVEF）、左室短轴缩短率（LVFS）等心功能指标。结果：78例维吾尔族心梗患者均在PCI术前及术后行心脏超声心动图检查。41例心肌存活组患者术前LVEF值42.21±6.79，在术后，其LVEF值提升至48.21±5.68，P<0.01；LVFS值由15.97±4.46升至26.68±7.34，P<0.01；手术前后心功能改善明显，统计学意义显著。无心肌存活组患者37例，术前LVEF值41.31±3.84，术后LVEF值42.13±3.65，P<0.01；术前LVFS值16.64±5.79，术后LVFS值18.51±3.75，P<0.01；心功能改善不佳，手术前后比较无统计学意义。结论：99mTc-MIBI心肌灌注联合18F-FDG心肌代谢显像能够有效检测维吾尔族心肌梗死患者的存活心肌，有存活心肌的患者在PCI术后其心功能得到明显改善。故双核素心肌显像对维吾尔族心肌梗死患者的PCI术有临床指导价值。

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	居热提·阿扎提
	艾娜
	阿不都热合满·买买提
	徐小煌

关键词 ：心肌梗塞, 血管成形术, 经腹, 经皮冠状动脉, 放射性核素血管显像术

Abstract：Objective: To investigate the value of fluorodeoxyglucose(18F-FDG) myocardial metabolic imaging combined with 99mTc-MIBI myocardial perfusion imaging in evaluating the Uygur's myocardial infarction and to investigate the effect of surviving myocardium after percutaneous coronary intervention(PCI) on cardiac function in Uygur patients with myocardial infarction. Methods: 78 cases of Uygur patients diagnosed with myocardial infarction, including 40 males and 38 females, aged 45 to 72 years, mean age 51±14 years old. All patients were confirmed by coronary angiography at least one coronary artery occlusion, all patients underwent 99mTc-MIBI myocardial perfusion imaging and 18F-FDG myocardial metabolism imaging before PCI. According to the results of dual-nuclide imaging, the patients were divided into myocardial survival group and no myocardial survival group. Left ventricular ejection fraction(LVEF) and left ventricular short axis shortening(LVFS) were compared between the two groups before and after operation. Results: 78 patients with Uygur heart disease were examined by echocardiography before and after PCI. In the myocardial survival group(41 patients), LVEF was 42.21±6.79 before operation, and the LVEF value increased to 48.21±5.68(P<0.01) after operation; LVFS value increased from 15.97±4.46 to 26.68±7.34, P<0.01; The myocardial function got improved significantly. In the no myocardial survival group, the LVEF value was 41.31±3.84, the postoperative LVEF was 42.13±3.65, P<0.01, the LVFS was 16.64±5.79, the postoperative LVFS was 18.51±3.75, P<0.01; the cardiac function got poor improvement, the difference between before and after surgery was not statistically significant. Conclusion: 99mTc-MIBI myocardial perfusion combined with 18F-FDG myocardial metabolism can effectively detect the viable myocardium of Uygur patients with myocardial infarction, so that patients with viable myocardium have improved their cardiac function after PCI. Therefore, dual-nuclide myocardial imaging has clinical guidance value for PCI in Uygur patients with myocardial infarction.

Key words： Myocardial infarction Angioplasty, transluminal, percutaneous coronary Radionuclide angiography

收稿日期: 2017-08-03

PACS:	Ｒ542.22
	Ｒ817.4

基金资助:新疆维吾尔自治区人民医院院内科研项目：双核素心肌显像检测心肌梗死患者存活心肌的临床价值（项目编号：20150226）。

通讯作者: 居热提·阿扎提，新疆维吾尔自治区人民医院核医学科，830001。E-mail：juratazat@163.com

作者简介: 居热提·阿扎提（1982-），男，新疆人，主治医师。E-mail：juratazat@163.com

引用本文:

居热提·阿扎提，艾娜，阿不都热合满·买买提，徐小煌. 心肌显像评价存活心肌对维吾尔族心肌梗死患者PCI术指导的临床价值[J]. 中国临床医学影像杂志, 2018, 29(5): 333-336.
JURETI Azhati, AI Na， ABUDU REHEMAN Maimaiti, XU Xiao-huang. Evaluation of myocardial viability in Uygur patients with myocardial infarction after percutaneous coronary intervention by dual core myocardial imaging. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(5): 333-336.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2018/V29/I5/333

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