急性心肌梗塞者~(99m)TC—PYP心肌闪烁图的形态与临床的关系

本文对80例AMI患者及12例非急性心肌梗塞者作~(99m)TC-PYP心肌闪烁图,旨在分析其强度及形态与临床关系,结果如下: 1.AMI组~(99m)TC-PYP心肌闪砾图阳性者77/80例,即敏感性96.2%,其中急性透壁心肌梗塞66/67例,急性心内膜下心肌梗塞11/13例。非急性心肌梗塞组12例,显示阳性者1例,即特异性92%。阳性组死亡6例,阴性组无死亡。 2.阳性组77例,局限型67例,其中2级者29例,3～4级者38例;环形10例,其中9例ECG均提示广泛前壁心肌梗塞,2例并有侧壁心肌梗塞,本组未发现弥漫型图形者。 3.~(99m)TC-PYP心肌闪烁图强度和形态与预后有密切关系。环形(炸面圈)者预后最差,局限型3～4级者预后次之,局限性2级者预后较好。心肌梗塞面积与预后的准确关系有待进一步研究。

The Patterns of TC-PYP Myocardial Scintigrams In AMI Patients and Their Clinical Correlations

Eighty patients with acute myocardial infarction and non-Acute Myocardial Infarction had myocardial scintigrams by technetium 99m stannous pyrophospate. The results were analysed to see the relationship between the activing and pattern of myocardial scintigram and clinical findings. The results are as follows: 1. In the AMI group, 77 had positive myocardial scintigrams. The sensitivity was 96.2%. Among those positive, 66 were acute transmural myocardial infarction and 11 were acute subendocardial myocardial infarction. In another group of 12 patients with non-acute myocardial infarction, only one showed positive myocardial scintigram. The specificity was 92%. Six died in the positive group while none died in the negative one. 2. In the positive group, of the 77, 67 had localized patterns. Among them, 29 were activity grading 2 , 38 were grading 3-4 . The other 10 were ring patterns. In this, 9 had ECG evidence of diffuse anterior AMI. of the 10, 2 also complicated with lateral AMI. None in positive group had diffuse pattern. 3. The study also revealed that the activity and pattern of TC-PYP myocardial scintigram had close relation with prognosis: the prognosis of ring pattern was the worst, the localized pattern with grading 3-4 was not so had and the localized pattern with grading 2 was relatively better. The exact relationship between the area of infarction and prognosis needs a further study.