Wahl J M, Hakki A H, Iskandrian A S, Yacone L
Am Heart J. 1985 Apr;109(4):769-75. doi: 10.1016/0002-8703(85)90637-4.
This study examines the scintigraphic features of patients in Killip class I or II after acute myocardial infarction (AMI) with relation to ECG changes. The 41 consecutively studied patients (23 men and 18 women) with first AMI were divided into two groups: group 1 (n = 25) had Q wave AMI, and group 2 (n = 16) had non-Q wave AMI. Rest thallium-201 myocardial scintigrams and radionuclide ventriculograms were obtained 10 days (mean) after AMI. The thallium images were divided into 15 segments in three projections and assessed qualitatively and quantitatively. Fixed perfusion defects were present in at least one segment in 23 patients (92%) in group 1 and in eight patients (50%) in group 2 (p = 0.007). All but one patient in group 1 (4%) and three patients in group 2 (19%) had perfusion defects (fixed or reversible). The number of segments with perfusion defects was 5.6 +/- 2.6 in group 1 and 2.9 +/- 2.3 in group 2 (p = 0.002); the peak creatine kinase was 1280 +/- 880 Units/L in group 1 and 360 +/- 340 Units/L in group 2 (p less than 0.001); the left ventricular ejection fraction was 38 +/- 14% in group 1 vs 43 +/- 15% in group 2 (p = NS). Thus fixed perfusion defects are present in 92% of patients with Q waves and in 50% of patients with no Q waves.
本研究探讨急性心肌梗死（AMI）后Killip I级或II级患者的闪烁显像特征及其与心电图变化的关系。连续研究的41例首次发生AMI的患者（23例男性和18例女性）被分为两组：第1组（n = 25）为Q波心肌梗死，第2组（n = 16）为非Q波心肌梗死。在AMI后10天（平均）进行静息铊-201心肌闪烁显像和放射性核素心室造影。铊图像在三个投影方向上分为15个节段，并进行定性和定量评估。第1组23例患者（92%）和第2组8例患者（50%）至少有一个节段存在固定灌注缺损（p = 0.007）。第1组除1例患者（4%）外，第2组除3例患者（19%）外，其余患者均有灌注缺损（固定或可逆）。第1组有灌注缺损的节段数为5.6±2.6，第2组为2.9±2.3（p = 0.002）；第1组肌酸激酶峰值为1280±880单位/L，第2组为360±340单位/L（p＜0.001）；第1组左心室射血分数为38±14%，第2组为43±15%（p =无显著性差异）。因此，92%的Q波患者和50%的非Q波患者存在固定灌注缺损。
