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|本期目录/Table of Contents|

冠状动脉闭塞血运重建术后存活心肌对心功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第3期
页码:
309-311
栏目:
临床研究
出版日期:
2006-06-25

文章信息/Info

Title:
Viable myocardium post revascularization after coronary arterial occlusion and its effects on ventricular function
作者:
李丹1; 吕安林1; 贾国良1; 汪静2; 李国权2; 陈丹1; 苑媛1
第四军医大学西京医院:1.心内科,2.核医学科,陕西 西安 710032
Author(s):
LI Dan1;  Lv An-lin1;  JIA Guo-liang1;  WANG Jing2;  LI Guo-quan2;  CHEN Dan1;  YUAN Yuan1
1. Department of Cardiology, 2. Department of Nuclear Medical, Xijing Hospital, Fourth Military Medical University, Xi′an, Shaanxi 710032, China
关键词:
冠状动脉闭塞; 血运重建; 存活心肌; 心功能; 双核素
Keywords:
coronary arterial occlusion;  revascularization;  viable myocardium;  ventricular function;  dualisotope
分类号:
R543.31；R445.5
DOI:
-
文献标识码:
A
摘要:
目的 观测冠状动脉闭塞血运重建术后存活心肌的情况,分析其对心功能恢复的影响。方法 选择30例冠状动脉闭塞的患者，分别于血运重建术前、术后6月行99mTcMIBI结合18FFDG心肌代谢的双核素心肌灌注显像方法检测存活心肌；根据灌注代谢情况来评价存活心肌的程度，术前心肌灌注代谢均减低者为无存活心肌(A组,n=12），心肌灌注减低而代谢正常者为有存活心肌(B组,n=18），通过超声心动图观察两组心功能的变化，并且对比评价术前、术后运动耐量的变化特点。结果 血运重建术后存活的心肌增加至180个节段；B组血运重建术后6月心功能恢复显著，左心室射血分数（LVEF）为(52±4)% vs (64±4)%（P<0.01）；心肌显像缺血程度较术前有明显改善，血运重建术后运动时间延长，运动距离增加；A组变化不明显。结论 冠状动脉闭塞血运重建术后存活心肌的数量与心功能的恢复密切相关。
Abstract:
AIM To observe the viable myocardium post revascularization after coronary occlusion and its effects on ventricular function. METHODS Viable myocardium was detected in 30 patients with coronary arterial occlusion before and after revascularization by 99mTcMIBI and 18FFDG dualisotope imaging and the extent of viable myocardium was assessed by the conditions of perfusionmetabolism. The patients with reduced myocardial perfusion and FDG uptake were arranged in group A (12) and the patients with reduced myocardial perfusion but normal FDG uptake were arranged in group B (18). The changes of ventricular function and the characteristics of exercise tolerance were observed. RESULTS After revascularization, the number of viable myocardium increased by 180 segments and the patients in group B showed a significant improvement in LVEF(52±4)% vs (64±4)% (P<0.01). The degrees of myocardial ischemia in group B changed significantly. The time of exercise tolerance prolonged and the distance increased in group B after revascularization, while no significant changes were found in the patients of group A. CONCLUSION The number of viable myocardium is directly related with the recovery of ventricular function after revascularization.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2005-09-12.基金项目：总后卫生部重点科研基金项目资助(No.012088) 通讯作者：吕安林,副主任医师，副教授，主要从事冠状动脉介入治疗研究 Tel：（029）84775183 作者简介：李丹,主治医师，硕士生 Tel：(041)85849477
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