扩张性心肌病病人心肌MIBI清除率的临床初步研究-影像医学与核医学专业论文.docxVIP

线粒体膜结构破坏、负电势消失，大量99Tc”一M1BI从线粒体快速释出。因 线粒体膜结构破坏、负电势消失，大量99Tc”一M1BI从线粒体快速释出。因 此，检测99Tcm-MIBI在心肌细胞内的廓清速度可反映其线粒体功能状态。 本研究目的在于探求能否用99Tc“．MIBI的清除率变化来评估心肌细胞功能 障碍的程度。 本研究结果显示”Tc”-MIBI在DCM病人心肌内早期及晚期清除率均 显著高于对照组，表明DCM病人心肌细胞内99Tcm MIBI清除加快。此结 果与有关学者的研究结果一致。此外，清除率与LVEF问的相关性研究显 示早期及晚期心肌内”Tcm-MIBI清除率与LYEF之闷有明显的负相关关系。 当DCM病人心肌细胞”Tcm-MIBI清除率加快时，提示其心肌细胞功能障 碍严重。”Tcm-MIBI心肌显像的同时检测’‰m-MIBI心肌内清除率的变化 可为临床在评价左室收缩功能方面提供又一有用信息。 有报道指出，在缺血性心脏病病人心肌内，辨，I矿一MIBI清除率比正常 人群要慢。因此，通过比较心肌内99Te“-MIBI清除率，可帮助鉴别缺血性 心肌病及扩张性心肌病。此外，在常规进行钙‰m-MIBI心肌显像时，同时 DCM病人心肌99Tcm-MIBI清除率明显快于正常人，且与左室射血分 数间有一定的相关性。通过清除率的计算，可对线粒体功能及心肌细胞功 能障碍的程度做出评价，帮助判断预后，并有助于临床鉴别扩张性心肌病 及缺血性心肌病。 关键词 心肌病，充血性： MIBI；放射性核素显像；心脏功能试验 Preliminary Preliminary clinical investigations of辨’I’c“．MIBl washout rate in diIated cardiomyopathy Abstract objective To investigate the change of washout rates of 99Tc。-MIBI in dilated cardiomyopathy(DCM)and explore the relationship between washout rate and left ventricular ejection fraction(LVEF)with myocardial radionuelide imagings． MateriaIs and methods Twelye healthy subjects and twenty．six patients who were diagnosed as DCM clinically underwent’’rc ．MIBI slatic planar imaging at ten minutes, ninety minutes and foⅢhours after injeelion．Gated SPECT imagings were carried out at ninety minutes sireullaneously．The outlines ofthe myocardium as regions of interesting(ROIs)were drawn in the three planar images融the sanle time．Then the mean Count of each pixⅥ佻calculated and attenuation corrects were made．respectively．Early and late washout rates were accounted using formula．The gated SPBCT irnagings were dealt with and the myocardial functional parameters were got．Then the early and late washout rates of ”Tc -MⅢI between DCM and control group were compared and linear correlative analysis between washout rates and LVEF measured by gated SPECT were made． Resuits The early and late washout rates of’‰m-MIBI in eontrol group were 17．58％±5．27％and 30．90％±7．22％，respectively．And the washout rate in DCM were 23．46％±5．23％and 38．6