目的 探討急性心肌梗死冠狀動脈介入治療（PCI）術(shù)后患者梗死區(qū)心肌存活性對左室重構(gòu)及功能的影響。 方法 2006年2月－2010年12月208例急性心肌梗死急診PCI術(shù)后的患者接受靜息狀態(tài)下18氟-脫氧葡萄正電子斷層顯像進(jìn)行心肌代謝顯像檢查，根據(jù)基線梗死區(qū)心肌有無存活分為兩組，同時進(jìn)行超聲心動圖檢查，評價左室壁運(yùn)動、左室射血分?jǐn)?shù)，左室舒張末內(nèi)徑、左房內(nèi)徑及舒張期二尖瓣血流速度峰值的比值。血運(yùn)重建術(shù)后12個月隨訪超聲心動圖，觀察梗死區(qū)心肌存活狀態(tài)對于左室重構(gòu)以及心功能的影響。 結(jié)果 PCI術(shù)后12個月，有存活心肌組左室射血分?jǐn)?shù)（46.7 ± 6.98）%高于無存活心肌組（45.1 ± 7.12）%，兩組差異有統(tǒng)計學(xué)意義（P＜0.01），有存活心肌組左室舒張末期內(nèi)徑（53.17 ± 3.89） mm小于無存活心肌組（55.46 ± 4.75） mm，兩組差異有統(tǒng)計學(xué)意義（P＜0.05）。左房內(nèi)徑及舒張期二尖瓣血流速度峰值的比值兩組隨訪時均無明顯變化。 結(jié)論 急性心肌梗死行PCI治療后的患者，在有存活心肌的情況下，心功能改善明顯；而梗死區(qū)無心肌存活的患者，12個月后，心功能減低，左室重構(gòu)更加明顯。
引用本文： 依力米努爾阿合買提江,彭輝. 心肌存活及灌注對急性心肌梗死冠狀動脈介入治療術(shù)后患者心功能的影響. 華西醫(yī)學(xué), 2012, 27(8): 1126-1128. doi: 復(fù)制
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| 1. | Machac J. Cardiac positron emission tomography imaging[J]. Semin Nucl Med, 2005, 35(1): 17-36. |
| 2. | Allman KC, Shaw LJ, Hachamovitch R, et al. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis[J]. J Am Coll Cardiol, 2002, 39(7): 1151-1158. |
| 3. | Kudo T. Metabolic imaging using PET[J]. Eur J Nucl Med Mol Imaging, 2007, 34(Suppl 1): S49-S61. |
| 4. | Gimelli A, Rossi G, Landi P, et al. Stress/rest myocardial perfusion abnormalities by gated SPECT: still the best predictor of cardiac events in stable ischemic heart disease[J]. J Nucl Med, 2009, 50(4): 546-553. |
| 5. | Stirrup J, Maenhout A, Wechalekar K, et al. Radionuclide imaging in ischaemic heart failure[J]. Br Med Bull, 2009, 92: 43-59. |
| 6. | Beanlands R, Nichol G, Huszti E, et al. F-18-fluorodeoxyglucose positron emission tomography imaging-assisted management of patients with severe left ventricular dysfunction and suspected coronary disease: a randomized, controlled trial (PARR-2)[J]. J Am Coll Cardiol, 2007, 50(20): 2002-2012. |
| 7. | Bax RH, van JJ, Veldhuisen DJ, et al. Prediction of functional recovery after revascularization in patients with chronic ischaemic left ventricular dysfunction:head-to-head comparison between 99mTcsestamibi/18F-FDG DISA SPECT and 13N-ammonia/18F-FDG PET[J]. Eur J Nucl Med Mol Imaging, 2006, 33(6): 716-723. |
| 8. | Zhang X, Liu XJ, Wu Q, et al. Clinical outcome of patients with previous myocardial infarction and left ventricular dysfunction assessed with myocardial (99m)Tc-MIBI SPECT and (18)F-FDG PET[J]. J Nucl Med, 2001, 42(8): 1166-1173. |
| 9. | Toyama T, Hoshizaki H, Seki R, et al. Evaluation of myocardial viability following acute myocardial infarction using 201Tl SPECT after thallium-glucose-insulin infusion--comparison with 18F-FDG positron emission tomography[J]. Ann Nucl Med, 2004, 18(6): 463-468. |
| 10. | Demirkol MO. Myocardial viability testing in patients with severe left ventricular dysfunction by SPECT and PET[J]. Anadolu Kardiyol Derg, 2008, 8(Suppl 2): 60-70. |
| 11. | Desideri A, Cortigiani L, Christen AI, et al. The extent of perfusion-F18-fluorodeoxyglucose positron emission tomography mismatch determines mortality in medically treated patients with chronic ischemic left ventricular dysfunction[J]. J Am Coll Cardiol, 2005, 46(7): 1264-1269. |
| 12. | Chareonthaitawee P, Gersh BJ, Araoz PA, et al. Revascularization in severe left ventricular dysfunction: the role of viability testing [J]. J Am Coll Cardiol, 2005, 46(4): 567-574. |
- 1. Machac J. Cardiac positron emission tomography imaging[J]. Semin Nucl Med, 2005, 35(1): 17-36.
- 2. Allman KC, Shaw LJ, Hachamovitch R, et al. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis[J]. J Am Coll Cardiol, 2002, 39(7): 1151-1158.
- 3. Kudo T. Metabolic imaging using PET[J]. Eur J Nucl Med Mol Imaging, 2007, 34(Suppl 1): S49-S61.
- 4. Gimelli A, Rossi G, Landi P, et al. Stress/rest myocardial perfusion abnormalities by gated SPECT: still the best predictor of cardiac events in stable ischemic heart disease[J]. J Nucl Med, 2009, 50(4): 546-553.
- 5. Stirrup J, Maenhout A, Wechalekar K, et al. Radionuclide imaging in ischaemic heart failure[J]. Br Med Bull, 2009, 92: 43-59.
- 6. Beanlands R, Nichol G, Huszti E, et al. F-18-fluorodeoxyglucose positron emission tomography imaging-assisted management of patients with severe left ventricular dysfunction and suspected coronary disease: a randomized, controlled trial (PARR-2)[J]. J Am Coll Cardiol, 2007, 50(20): 2002-2012.
- 7. Bax RH, van JJ, Veldhuisen DJ, et al. Prediction of functional recovery after revascularization in patients with chronic ischaemic left ventricular dysfunction:head-to-head comparison between 99mTcsestamibi/18F-FDG DISA SPECT and 13N-ammonia/18F-FDG PET[J]. Eur J Nucl Med Mol Imaging, 2006, 33(6): 716-723.
- 8. Zhang X, Liu XJ, Wu Q, et al. Clinical outcome of patients with previous myocardial infarction and left ventricular dysfunction assessed with myocardial (99m)Tc-MIBI SPECT and (18)F-FDG PET[J]. J Nucl Med, 2001, 42(8): 1166-1173.
- 9. Toyama T, Hoshizaki H, Seki R, et al. Evaluation of myocardial viability following acute myocardial infarction using 201Tl SPECT after thallium-glucose-insulin infusion--comparison with 18F-FDG positron emission tomography[J]. Ann Nucl Med, 2004, 18(6): 463-468.
- 10. Demirkol MO. Myocardial viability testing in patients with severe left ventricular dysfunction by SPECT and PET[J]. Anadolu Kardiyol Derg, 2008, 8(Suppl 2): 60-70.
- 11. Desideri A, Cortigiani L, Christen AI, et al. The extent of perfusion-F18-fluorodeoxyglucose positron emission tomography mismatch determines mortality in medically treated patients with chronic ischemic left ventricular dysfunction[J]. J Am Coll Cardiol, 2005, 46(7): 1264-1269.
- 12. Chareonthaitawee P, Gersh BJ, Araoz PA, et al. Revascularization in severe left ventricular dysfunction: the role of viability testing [J]. J Am Coll Cardiol, 2005, 46(4): 567-574.