心肌显像动态观察不稳定型心绞痛溶栓治疗效果

目的：用心肌断层显像方法动态观察静脉用尿激酶治疗不稳定型心绞痛（ＵＡＰ）的效果。方法：将４０例ＵＡＰ患者随机分为常规治疗组（Ⅰ组）和常规治疗＋尿激酶治疗组（Ⅱ组），分别于治疗前，治疗后第４天、１５天进行静息－小剂量多巴酚丁胺９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）心肌显像并进行对比研究。结果：Ⅱ组于治疗第４天有７５％（１５／２０）患者心肌显像缺血图像改善，与Ⅰ组３５％（７／２０）比较有显著差异（Ｐ＜０．０５），但第１５天两组患者的心肌显像缺血图像改善率均为４５％（９／２０）。随访１年两组间心脏事件发生率无差异。结论：心肌断层显像是评价ＵＡＰ静脉溶栓疗效的有价值方法，ＵＡＰ静脉溶栓部分病例早期可能有益，后期并未改善预后

EVALUATION OF THE THROMBOLYTIC THERAPEUTIC EFFECT ON PATIENTS WITH UNSTABLE ANGINA BY AMBULANT OBSERVATION OF MYOCARDIAL PERFUSION IMAGING

Objective:To evaluate the therapeutic effect of urokinase (UK) on patients with unstable angina pectoris (UAP) by ambulant observation of myocardial perfusion imaging (MPI).Methods:Forty patients with UAP were divided into two groups in randomized trial:conventional therapeutic group (group Ⅰ) and conventional combined with UK (group Ⅱ). Ischemic myocardial area (IMA) was studied by resting low dose dobutamine interventional 99m Tc MIBI MPI before and the 4th,15th day after treatment.Results:75%(15/20) patients of group Ⅱ were improved for IMA on the 4th day,while only 35%(7/20) patients of group Ⅰ were done.Both groups were different significantly (χ 2=6.46,P<0.05).But on the 15th day,there were 45%(9/20) patients being improved in both groups.Conclusions:MPI is a valuable method for evaluating the thrombolytic effect on patients with UAP.It is possible for them to benefit from thrombolytic therapy only in early stage,however prognosis is not improved in follow up period.