静脉溶栓治疗对急性心肌梗死梗死部位存活心肌的影响

目的研究静脉溶栓治疗对急性心肌梗死患者心肌存活状态的影响.方法采用硝酸甘油介入99mTc-MIBI心肌灌注显像的方法,评价37例行静脉溶栓治疗的急性心肌梗死患者梗死部位的存活心肌.结果静息显像中136个节段灌注异常,NTG介入后有81个节段得到不同程度的改善,改善率为59.56%;静息显像平均得分为8.35±3.71,介入显像平均得分为6.05±3.16,两者比较差别有统计学意义(P＜0.001);静脉溶栓再通组存活心肌检出率为76.86%,未通组及常规治疗组为44.44%,再通组明显高于未通组,且有统计学意义(P＜0.01).结论硝酸甘油介入99mTc-MIBI心肌显像可明显提高存活心肌的检出率,成功的溶栓治疗可使梗塞区保留较多的存活心肌.

Identification of viable myocardium in the regions of acute myocardial infarction

Objective To identify viable myocardium in the regions of acute myocardial infarction by myocardial perfusion imaging.Methods Technetium -99m-sestamibi imaging with nitroglycerin sublingual to evaluate myocardial viability in 37 patients with Q wave acute myocardial infarction.Results In 37 patients,136 segment is decreased in rest perfusion imagining, 81 segment is improved in nitroglycerin intervention imagining, the incidence of viability myocardium is 59.56%; successful thrombolytic treatment group is higher than, without successful thrombolytic treatment and routine treatment group in the detection of viability myocardium( 76.86% vs 44.44% ,P<0.01). ConclusionViable myocardium may exist regardless of thrombolysis, but thrombolysis keeps more jeopardized myocardium viable.