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从运动铊-201心肌显像考虑心肌梗死区域的主动脉-冠状动脉搭桥手术指征

Indication of aorto-coronary bypass graft surgery for infarction area of myocardium considered from exercise thallium-201 myocardial imagings.

作者信息

Ebine K, Tamura S, Lee M, Sato K, Kubo H, Sakai M, Sugi K, Ukai K

机构信息

Division of Cardiovascular Surgery, Toho University Ohashi Hospital, Tokyo, Japan.

出版信息

Jpn Circ J. 1987 Jun;51(6):595-603. doi: 10.1253/jcj.51.595.

Abstract

To assess accurately the indication and effects of aorto-coronary bypass graft surgery (ACBG) to the myocardium infarction area, 35 patients with myocardial infarction were analyzed by using exercise thallium-201 myocardial imagings. The patients were classified into group I (18 cases) and group II (17 cases) before ACBG. Group I consisted of patients with regional hypoperfusion in the initial image who showed redistribution in the delayed image to the infarction area of myocardium. Group II consisted of those with regional hypoperfusion in the initial image without redistribution in the delayed image. Group I showed a significant improvement in myocardial perfusion (p less than 0.01), pressure rate product (p less than 0.01), global left ventricular ejection fraction (p less than 0.01), segmental wall motion abnormality (p less than 0.01), and exercise tolerance when compared with those of group II before and after ACBG. The above study showed that the pre- operative redistribution of the infarction area in the delayed image suggests myocardial viability and ACBG will be effective.

摘要

为准确评估主动脉冠状动脉搭桥术(ACBG)对心肌梗死区域的适应证及效果,采用运动铊-201心肌显像对35例心肌梗死患者进行分析。在ACBG术前,将患者分为I组(18例)和II组(17例)。I组患者初始显像时有局部灌注减低,延迟显像时梗死心肌区域出现再分布。II组患者初始显像时有局部灌注减低,延迟显像时无再分布。与II组相比,I组在ACBG术前及术后的心肌灌注(p<0.01)、压力心率乘积(p<0.01)、整体左心室射血分数(p<0.01)、节段性室壁运动异常(p<0.01)及运动耐量方面均有显著改善。上述研究表明,延迟显像时梗死区域术前出现再分布提示心肌存活,ACBG将会有效。

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