腺苷负荷心肌核素显像评价冠脉慢性完全闭塞病变存活心肌的临床研究Clinical research of myocardial perfusion imaging using adenosine loading 201Tl on myocardial viability in the area of coronary chronic vascular occlusion
王赟赟,黄榕翀,周旭晨,张妍,梁滨,朱皓,郑振国,王少鹏,尹达,王俊杰,张波
摘要(Abstract):
目的应用腺苷负荷201Tl心肌灌注显像评价冠心病慢性血管闭塞相关区域存活心肌的准确性和安全性。方法 30例经16层CT冠状动脉成像(CTA)检查证实为冠心病慢性血管闭塞病变患者,经皮冠脉介入治疗(PCI)术前行腺苷负荷心肌核素显像检查。按恒定速度静脉注射腺苷(0.14mg·kg-1.min-1),在开始注射腺苷后第3分钟末静脉注射201Tl111MBq(3mCi),至开始注射腺苷后第6分钟末停止腺苷注入。10min后采集负荷相,3h后采集再分布影像。所有患者同期(1周内)均行冠状动脉造影术(CAG)检查。结果 30例经冠脉CTA证实为冠状动脉慢性完全闭塞病变(CTO)的患者中,CAG证实其中21例存在侧支循环,9例无侧支循环,按照CAG检查确定是否存在侧支循环分为侧支循环阳性组和侧支循环阴性组,分别对两组各节段负荷显像与延迟显像积分相减得出积分差。结果发现,存在侧支循环组患者平均积分差值为1.03±0.84,没有侧支循环组患者平均积分差值为0.31±0.56(P=0.033),差异具有统计学意义。结论腺苷负荷201Tl心肌灌注显像可以很好地评价冠心病慢性血管闭塞相关区域存活心肌。各节段负荷显像与延迟显像积分差越大,存活心肌越多,且与是否存在侧支循环有关。
关键词(KeyWords): 放射性核素显像;冠状动脉闭塞;心肌再灌注
基金项目(Foundation):
作者(Author): 王赟赟,黄榕翀,周旭晨,张妍,梁滨,朱皓,郑振国,王少鹏,尹达,王俊杰,张波
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