Nicod P, Lewis S E, Corbett J C, Buja L M, Henderson G, Raskin P, Rude R E, Willerson J T
Am Heart J. 1982 May;103(5):822-9. doi: 10.1016/0002-8703(82)90394-5.
"Persistently abnormal" technetium-99m stannous pyrophosphate myocardial scintigrams (PPi+) appear to be associated with a relatively poor prognosis after acute myocardial infarction (AMI). To assess the incidence and implications of PPi+, we performed a retrospective analysis in 29 patients with and 25 patients without diabetes mellitus who had abnormal myocardial scintigrams within 4 days of AMI and who had follow-up scintigrams at least 3 months after hospital discharge. There were no significant differences between patients with and without diabetes as regards age, incidence of transmural or nontransmural AMI, or degree of left ventricular dysfunction after AMI. Persistently abnormal PPi+ occurred more commonly in patients with diabetes than in nondiabetic patients (18 of 29, 62%, compared to 3 of 25, 12%; p less than 0.001). Patients with chronic PPi+ had more frequent cardiac complications following hospital discharge (p less than 0.005) including death, recurrent AMI, unstable angina, and intractable congestive heart failure. Postmortem analysis in two patients with diabetes and chronic PPi+ revealed marked myocytolysis. Thus, patients with diabetes mellitus have an increased incidence of post-AMI "persistently abnormal" technetium (PPi+) scintigrams and relatively poor prognosis following myocardial infarction.
“持续异常”的锝-99m焦磷酸亚锡心肌闪烁图（PPi+）似乎与急性心肌梗死（AMI）后的相对较差预后相关。为了评估PPi+的发生率及其影响，我们对29例糖尿病患者和25例非糖尿病患者进行了回顾性分析，这些患者在AMI后4天内心肌闪烁图异常，且在出院后至少3个月进行了随访闪烁图检查。在年龄、透壁或非透壁AMI的发生率或AMI后左心室功能障碍程度方面，糖尿病患者和非糖尿病患者之间没有显著差异。持续性异常的PPi+在糖尿病患者中比非糖尿病患者更常见（29例中有18例，62%，相比之下25例中有3例，12%；p<0.001）。慢性PPi+患者出院后心脏并发症更频繁（p<0.005），包括死亡、复发性AMI、不稳定型心绞痛和难治性充血性心力衰竭。对两名患有糖尿病和慢性PPi+的患者进行的尸检分析显示明显的心肌溶解。因此，糖尿病患者AMI后“持续异常”的锝（PPi+）闪烁图发生率增加，心肌梗死后预后相对较差。
