^99Tc^m-MIBI运动负荷-静息心肌灌注显像对冠心病患者经皮腔内冠状动脉血管成形术的疗效评价

目的 用^99Tc^m-甲氧基异丁基异腈（^99Tc^m-MIBI）运动-静息心肌灌注显像评价经皮腔内冠状动脉成形术（PTCA）的疗效。方法20例冠心病患者在PTCA术前和术后应用^99Tc^m-MIBI行运动负荷．静息心肌灌注显像，并对图像进行半定量分析。其中8例患者于术后6个月再次心肌灌注显像。结果对20例患者的27支冠状动脉呈狭窄病变进行PTCA，术前血管的平均狭窄为（84．3±9．2）％，术后平均残留狭窄减为（31．2±9．1）％。运动负荷-静息显像显示可逆性缺损（心肌缺血）的心肌节段数由术前的55个（30．6％）减为术后的10个（5．6％），差异有显著性（x^2=38．02，P〈0．005）。术后心肌灌注的改善率为81．8％，8例患者术后6个月心肌显像显示3例出现缺血节段，冠状血管造影证实为再狭窄。结论^99Tc^m-MIBI运动负荷-静息心肌灌注显像是一种有效的无创性的判断PTCA术后疗效及再狭窄的方法。

Evaluation of the outcomes of ^99Tc^m-MIBI stress-rest perfusion imaging in coronary heart disease with percutaneous transluminal coronary angioplasty

Objective To evaluate the outcomes of stress-rest ^99Tc^m-MIBI perfusion imaging in patients with percutaneous transluminal coronary angioplasty （PTCA）. Methods Twenty patients with coronary heart disease underwent repeated ^99Tc^m-MIBI stress-rest perfusion imaging before and after PTCA, and semi-quantitative analysis, 8 cases of them repeated coronary angiography after 6 monthes. Results Twenty patients with total of 27 coronary artery stenosis were distended, the average vascular stenosis were （84.3 ±9.2） % before PTCA, and were reduced to （ 31.2±9.1 ） % after PTCA. Stress-rest perfusion imaging showed myocardial segments were reversible defect （myocardial ischemia） from 55 （30.6%） befor PTCA to 10 （5.6%） after PTCA, there were significant difference （X2=38.02, P〈0.005） . The improved rate was 81.8%, 8 patients underwent repeated stress-rest SPECT imaging after 6 monthes, 3 cases appears ischemia segment, and coronary angiography confirmed was restenosis. Conclusion ^99Tc^m-MIBI stress-rest perfusion imaging is a useful noninvasive method for evaluating the effect of PTCA and for restenosis.