核素乏氧显像评估急性心肌梗死患者预后的价值

目的 探讨99mTc-HL91乏氧显像评估急性心肌梗死(AMI)患者预后的价值.方法 78例AMI患者在治疗前行99mTc-HL91乏氧显像检测心肌活性,并计算梗死心肌的99mTc-HL91摄取率.根据摄取率高低分为高摄取、低摄取和无摄取组,随访1年以上,对3组患者心脏不良事件的发生率进行比较.并根据定性诊断结果分为存活心肌组和坏死心肌组,对组内接受再血管化治疗和药物治疗患者的心脏不良事件发生率进行比较.结果 梗死心肌不同99mTc-HL91摄取比值的3组患者心脏不良事件发生率比较差异有显著性,无摄取组发生率较高,高摄取组发生率较低.存活心肌组内接受药物治疗的患者心脏不良事件发生率明显高于再血管化治疗者,差异有显著性,而坏死心肌组内治疗方法不同,心脏不良事件发生率比较差异无显著性.结论 99mTc-HL91乏氧显像检测存活心肌有助于鉴别AMI高危患者、判断预后,并对指导临床选择治疗方法有一定的应用价值.

Prognostic value of nuclide hypoxia imaging in patients with acute myocardial infarction

[Objective] To investigate the prognostic value of 99mTc-HL91 hypoxia imaging in patients with acute myocardial infarction(AMI).[Methods] 78 AMI patients were performed 99mTc-HL91 hypoxia imaging to detect the myocardial viability,calculated 99mTc-HL91 uptake rate of infarction myocardium.All patients were divided into 3 groups by the level of 99mTc-HL91 uptake rate and followed up above 1 year,compared the incidence rate of hard events to 3 groups.And divided the patients into viable myocardium group and necrotic myocardium group,compared the incidence rate of hard events of the patients underwent revascularization with the patients underwent drug treatment in each group.[Results] In 3 groups which 99mTc-HL91 uptake rate of infarction myocardium were different,the incidence rate of hard events had obvious difference,the non-uptake group was higher,and the high-uptake group was lower.In viable myocardium group,the incidence rate of the patients underwent drug treatment was higher than that of the patients underwent revascularization,the difference had significance,and hadn't significance in necrotic myocardium group.[Conclusion] Using 99mTc-HL91 hypoxia imaging to detect the viable myocardium is helpful to identify high risk and can estimate the prognosis for AMI patients,and can guide the clinic to choose the therapy.