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经皮腔内冠状动脉成形术前后的201铊心肌闪烁显像

[201-thallium myocardial scintigraphy before and after percutaneous transluminal coronary angioplasty].

作者信息

Munck O, Hansen P F, Kelbaek H S, Folke K

机构信息

Klinisk fysiologisk/nuklearmedicinsk atdeling, Københavns Amts Sygehus, Herlev.

出版信息

Ugeskr Laeger. 1992 Jan 6;154(2):78-82.

PMID:1736432
Abstract

We describe our experience from the first 30 patients treated with percutaneous transluminal coronary angioplasty (PTCA) in the Cardiologic Department P, Gentofte Hospital. The main purpose was to evaluate the value of thallium scintigraphy performed before and three months after PTCA. After PTCA, 23 (77%) had no angina and 22 (73%) had normal exercise-ECG. On the basis of the scintigraphies before PTCA, the patients were divided into two groups: In group 1, five had normal scintigraphy and 14 reversible perfusion defects only. In group 2, all 11 patients had both persistent and reversible defects. In patients without persistent defects, significantly more were free from angina. No difference was observed between group 1 and 2 in percentage stenosis of the vessel or in reduction of the diameter. Significant reduction in the extent of reversible perfusion defects after PTCA was observed in both groups and also in the extent of persistent defects in group 2. In about 1/3 of the patients, the changes in percentage stenosis after PTCA and in the perfusion as judged by the scintigraphies differed. Therefore, as the two methods supplement each other, the main conclusions are: 1) Evaluation of the revascularization procedure is more reliable if a scintigraphy is obtained both before and after PTCA than if only coronary arteriography is performed. 2) Scintigraphy alone suffices for the three-month follow-up examination, partly because it gives better information about the myocardial perfusion than does the arteriography, partly because scintigraphy is a noninvasive procedure.

摘要

我们描述了根措夫特医院P心内科对首批30例接受经皮腔内冠状动脉成形术(PTCA)治疗的患者的治疗经验。主要目的是评估PTCA术前及术后三个月进行的铊闪烁扫描的价值。PTCA术后,23例(77%)无心绞痛,22例(73%)运动心电图正常。根据PTCA术前的闪烁扫描结果,患者被分为两组:第1组,5例闪烁扫描正常,仅14例有可逆性灌注缺损。第2组,所有11例患者均有持续性和可逆性缺损。在无持续性缺损的患者中,无心绞痛的患者明显更多。第1组和第2组在血管狭窄百分比或直径缩小方面未观察到差异。两组均观察到PTCA术后可逆性灌注缺损范围显著缩小,第2组持续性缺损范围也显著缩小。在约1/3的患者中,PTCA术后狭窄百分比的变化与闪烁扫描判断的灌注变化不同。因此,由于这两种方法相互补充,主要结论是:1)如果在PTCA术前和术后都进行闪烁扫描,而不是仅进行冠状动脉造影,对血运重建手术的评估更可靠。2)仅闪烁扫描就足以进行三个月的随访检查,部分原因是它比动脉造影能提供更好的心肌灌注信息,部分原因是闪烁扫描是一种非侵入性检查。

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