Niitsu N, Yamazaki J, Nakayama M, Umeda M, Morishita T
First Department of Internal Medicine, Toho University School of Medicine.
Gan To Kagaku Ryoho. 1995 Nov;22(13):1941-5.
In 59 patients with hematologic malignancy undergoing chemotherapy regimens including adriamycin (ADR), myocardial imaging was performed by SPECT with 123I-metaiodobenzylguanidine (MIBG) to detect cardiac sympathetic nerve abnormalities. SPECT imaging was performed 20 min and 4 hr after intravenous injection of 123I-MIBG, and the washout rate (WR) for the entire left ventricle was calculated. Then the relationship of the WR to the total dose of ADR, the left ventricular ejection fraction, and the frequency of arrhythmias was evaluated. It was found that the WR was related to the total dose of ADR, suggesting that it is a useful parameter for cardiac sympathetic nerve damage. As the WR increased, the frequency of ventricular arrhythmias also increased. The WR was usually normalized 3-6 months after the discontinuation of ADR. In patients with a WR > or = 50%, however, prolonged follow-up was required. In conclusion, the WR on 123I-MIBG myocardial SPECT scans may be useful as a parameter for predicting cardiac toxicity requiring the discontinuation of ADR or dose reduction.
在59例接受包含阿霉素（ADR）的化疗方案的血液系统恶性肿瘤患者中，采用单光子发射计算机断层扫描（SPECT）及123I-间碘苄胍（MIBG）进行心肌显像，以检测心脏交感神经异常。静脉注射123I-MIBG后20分钟和4小时进行SPECT显像，并计算整个左心室的洗脱率（WR）。然后评估WR与ADR总剂量、左心室射血分数及心律失常发生频率之间的关系。结果发现WR与ADR总剂量相关，提示其是评估心脏交感神经损伤的有用参数。随着WR升高，室性心律失常的发生频率也增加。停用ADR后，WR通常在3至6个月恢复正常。然而，对于WR≥50%的患者，需要延长随访时间。总之，123I-MIBG心肌SPECT扫描的WR可能作为预测需要停用ADR或降低剂量的心脏毒性的参数。
