Vorster M, Sathekge M M, Rheeder P
Department Pharmacology, Steve Biko Academic Hospital, University of Pretoria, South Africa.
Cardiovasc J Afr. 2010 May-Jun;21(3):142-7.
We sought to determine whether taking oral erythromycin prior to SPECT myocardial perfusion imaging with Tc99m-sestamibi would reduce the amount of interfering extra-cardiac activity and improve the image quality.
A total of 96 patients who were routinely referred for myocardial perfusion imaging were randomly assigned to one of two groups. Patients in group A received 500 mg of non-enterically coated erythromycin orally one hour prior to image acquisition (45 patients). Patients in group B received diluted lemon juice which comprises the current standard of care in our department (51 patients). A two-day protocol was followed and study participants received the same intervention on both days. Planar images of both the stress and rest images were assessed visually by three experienced nuclear medicine physicians for the presence of interfering extracardiac activity. Physicians were blinded to the detail of the protocol and independently assessed the images.
The qualitative results favoured lemon juice in reducing the amount of interfering extra-cardiac activity. The overall incidence of interfering extra-cardiac activity was 46.15% in the lemon juice group vs 55.56% in the erythromycin group. However, this difference was not found to be statistically significant (p = 0.36). The use of a MYO:EXT ratio similar to the one described by Peace and Lloyd,11 appeared promising in quantifying interfering extra-cardiac activity.
The difference between the effect of erythromycin and lemon juice on interfering extra-cardiac activity appears statistically insignificant and erythromycin could therefore be considered as a suitable alternative to lemon juice.
我们试图确定在使用锝99m-司他米比进行单光子发射计算机断层扫描（SPECT）心肌灌注成像之前口服红霉素是否会减少心脏外干扰活动的量并改善图像质量。
总共96例常规转诊进行心肌灌注成像的患者被随机分为两组。A组患者在图像采集前1小时口服500mg非肠溶红霉素（45例患者）。B组患者接受稀释柠檬汁，这是我们科室目前的标准护理措施（51例患者）。遵循为期两天的方案，研究参与者在两天内接受相同的干预。由三位经验丰富的核医学医生对负荷和静息图像的平面图像进行视觉评估，以确定是否存在心脏外干扰活动。医生对方案细节不知情，并独立评估图像。
定性结果表明柠檬汁在减少心脏外干扰活动量方面更具优势。柠檬汁组心脏外干扰活动的总体发生率为46.15%，而红霉素组为55.56%。然而，未发现这种差异具有统计学意义（p = 0.36）。使用类似于Peace和Lloyd所描述的心肌与心外组织放射性计数比来量化心脏外干扰活动似乎很有前景。
红霉素和柠檬汁对心脏外干扰活动的影响差异在统计学上似乎不显著，因此红霉素可被视为柠檬汁的合适替代品。
