201Tl-GIK溶液心肌灌注显像对陈旧性心肌梗塞患者存活心肌的判断

采用²⁰¹Tl-GIK溶液(²⁰¹铊-葡萄糖-胰岛素-氯化钾)心肌灌注显像,对28例陈旧性心肌梗塞患者的梗塞区域心肌的存活性进行研究。输注GIK溶液后再次心肌断层显像,结果:在28例陈旧性心肌梗塞患者的119个梗塞节段中有45个节段(37.8%)有存活心肌。15例做经皮冠状动脉内气囊扩张术或冠状动脉搭桥术的患者,术前76个梗塞节段中有28个节段于输注GIK溶液后显像证明有存活心肌(36.8%);术后复查静态201Tl心肌断层显像有32个节段存活(42%),两者间符合率为87.5%(28/32)。本研究证明在陈旧性心肌梗塞区内仍有存活心肌存在。

Detecting Hibernated Myocardium in Patients with Older Myocardial Infarction with SPECT and Thallium-GIK Infusion

To observe myocardial viability in infarcted area in patients with older myocardial infarction,we perfomed pilot study to identify the severely ischemic myocardium using the infusion of a thallium glucose insulin potassium solution.Results were compared with those obtained in rest images. In 336 segments of 28 patients ²⁰¹Tl rest images,45 out of 119 infarction segments,revealed ²⁰¹Tl activity after GIK infusion 37.8%。 In 180 segments of 15 patients with PTCA or CABG,28 out of the 76 infarction segments revealed ²⁰¹Tl activity after GIKinfusion 36.8%。42% segments with rest images were detected after operation.These results confirm that continuous infusion of ²⁰¹Tl with a low dose of insulin in a glucose and potassium chloride solution is safe and may enhance cellular uptake of the radiotracer in severely ischemic regions especially in older myocardial infarction.This study suggests that within the old infarcted area,there still exists viable myocardium.