99mTc-甲氧基异丁基异腈静息心肌显像在急性缺血性脑卒中引起心肌损伤中的应用

目的探讨^99mTc-甲氧基异丁基异腈(^99mTc-MIBI)静息心肌显像在急性缺血性脑卒中引起的继发性心肌损伤中的临床应用价值。方法选择延安大学咸阳医院2008年8月至2016年12月收治的急性缺血性脑卒中心肌酶谱持续升高,临床考虑继发心肌损伤的患者48例作为观察组,短暂性脑缺血发作,无明确心肌酶谱升高的患者37例作为对照组纳入研究,均行^99mTcMIBI静息心肌显像,采用4点积分法评分。比较两组灌注异常节段比例以及两组患者的平均节段积分。结果观察组呈非节段性放射性减低、灶性缺损或花斑样改变,对照组多呈节段性放射性减低或缺损或正常表现。观察组异常节段数比例(39.81%)高于对照组(30.63%),差异有统计学意义(χ²=6.892,P<0.05)。观察组平均评分(6.37±4.25)分高于对照组(4.21±3.78)分,差异有统计学意义(t=2.438,P<0.05)。结论^99mTc-MIBI静息心肌显像对急性缺血性脑卒中引起的继发性心肌损伤的范围和程度的评价有一定的价值。

Application of 99mTc-methoxyisobutylisonitrile rest myocardial perfusion imaging in myocardial injury caused by acute ischemic stroke

Objective To investigate the clinical value of ^99mTc-methoxyisobutylisonitrile(^99mTc-MIBI)rest myocardial perfusion imaging in secondary myocardial injury caused by acute ischemic stroke.Methods 48 patients with acute ischemic stroke whose myocardial enzymes was continuously elevated and were clinically considered to be related to secondary myocardial injury were selected as the observation group,37 volunteers with transient ischemic attacks whose myocardial enzymes didn’t increase continuously were enrolled as control group,all patients were from Xianyang Hospital of Yan’an University from August 2008 to December 2016.All patients underwent ^99mTc-MIBI rest myocardial perfusion imaging.Chi square test was used to compare the proportion of perfusion abnormal segments in two groups.The proportion of perfusion abnormal segments and average segment score were compared between the two groups.Results The observation group showed non segmental radioactivity decrease,focal defect or mottled change.The control group showed mostly segmental radioactivity decrease,defect or normal.The proportion of segmental myocardial perfusion reduction in observation group(39.81%)was higher than that in control group(30.63%),and the difference was statistically significant(χ²=6.892,P<0.05).The average score in observation group(6.37±4.25)was higher than that of control group(4.21±3.78),the difference was statistically significant(t=2.438,P<0.05).Conclusion ^99mTc-MIBI myocardial perfusion imaging is valuable in the evaluation of the extent and degree of secondary myocardial injury caused by acute ischemic stroke.