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[运用¹²³I - BMIPP和²⁰¹Tl心肌单光子发射计算机断层扫描比较不稳定型心绞痛与稳定型劳力性心绞痛]

[Comparison between unstable angina pectoris and stable effort angina pectoris by using 123I-BMIPP and 201Tl myocardial SPECT].

作者信息

Hisatake Shinji, Yamashina Shohei, Yamazaki Junichi

机构信息

Division of Cardiovascular Medicine, Department of Internal Medicine, Ohmori Hospital, Toho University School of Medicine.

出版信息

Kaku Igaku. 2004 Feb;41(1):9-16.

Abstract

We performed BMIPP myocardial SPECT and Tl myocardial SPECT in patients with unstable angina (UAP) and stable effort angina (SAP), and compared the results for the two groups. Our subjects were 30 patients with the UAP and 25 patients with the SAP. The early and delayed images of the BMIPP were obtained with patients at rest. The early image of the Tl alone was obtained with patients at rest. We calculated severity score (SS) using the polar map based on SPECT short-axis image on the both myocardial SPECT. And, we calculated % uptake of the responsible coronary lesion and regional washout rate (WR) on myocardial SPECT with BMIPP. On coronary angiogram, no difference in % diameter stenosis was seen between the two groups. On myocardial SPECT with Tl, no difference in the SS was seen between the two groups. However, on myocardial SPECT with BMIPP, the SS was significantly higher score in the UAP group than in the SAP group. And, on myocardial SPECT with BMIPP, the % uptake and the WR were significant lower values in the UAP group than in the SAP group. Even if the two groups have almost the same level of myocardial perfusion disorder, the UAP group may have severer myocardial fatty-acid metabolic disorder than the SAP group, because the defects in BMIPP were significantly severer in the UAP group.

摘要

我们对不稳定型心绞痛(UAP)患者和稳定型劳力性心绞痛(SAP)患者进行了BMIPP心肌单光子发射计算机断层扫描(SPECT)和铊心肌SPECT检查,并比较了两组的结果。我们的研究对象为30例UAP患者和25例SAP患者。BMIPP的早期和延迟图像是在患者静息状态下获得的。铊的早期图像仅在患者静息状态下获得。我们基于两种心肌SPECT的短轴图像,使用极坐标图计算严重程度评分(SS)。并且,我们计算了BMIPP心肌SPECT上责任冠状动脉病变的摄取百分比和区域洗脱率(WR)。在冠状动脉造影上,两组之间的直径狭窄百分比没有差异。在铊心肌SPECT上,两组之间的SS没有差异。然而,在BMIPP心肌SPECT上,UAP组的SS显著高于SAP组。并且,在BMIPP心肌SPECT上,UAP组的摄取百分比和WR显著低于SAP组。即使两组的心肌灌注紊乱程度几乎相同,但UAP组可能比SAP组存在更严重的心肌脂肪酸代谢紊乱,因为UAP组中BMIPP的缺损明显更严重。

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