Kobayashi H, Miyagi M, Nakajima H, Watanabe T, Nagai Y, Ibukiyama C
Second Department of Internal Medicine, Tokyo Medical College.
Kaku Igaku. 1994 Oct;31(10):1227-36.
Dual SPECT using 99mTc-PYP and 201Tl was performed in 70 patients with acute myocardial infarction, and the ratio of overlap zone between 201Tl and 99mTc-PYP uptake in the infarcted area was determined (the Y-ratio). The Y-ratio was significantly higher in the group with redistribution in the infarcted area on exercise thallium myocardial scintigraphy in the chronic stage of infarction, as well as in the group with normal left ventricular wall motion. Thus, the Y-ratio value was apparently useful in the evaluation of myocardial viability. Patients from 60% of the Y-ratio upward are suggested that myocardial viability had been survived. When the Y-ratio was determined in 30 patients who underwent early reperfusion therapy (ICT or direct-PTCA), no significant difference was found between the ICT group and the direct-PTCA group. However, the Y-ratio was significantly higher when reperfusion was performed within 6 hours than when it was performed after 6 hours, and a significant positive correlation (r = 0.63, p < 0.01), was found between reperfusion time from cardiac event within 9 hours and the value of (100--the Y-ratio).
The Y-ratio was grateful appeared to be useful for the quantitative evaluation of myocardial viability in the acute stage of myocardial infarction. In addition, it appears to be important to perform reperfusion as soon as possible to improve myocardial salvage.
对70例急性心肌梗死患者进行了使用99mTc-PYP和201Tl的双SPECT检查，并测定了梗死区域内201Tl与99mTc-PYP摄取重叠区的比值（Y比值）。在梗死慢性期运动铊心肌闪烁显像显示梗死区域有再分布的组以及左心室壁运动正常的组中，Y比值显著更高。因此，Y比值在评估心肌活力方面显然有用。Y比值在60%及以上的患者提示心肌活力尚存。在30例接受早期再灌注治疗（ICT或直接PTCA）的患者中测定Y比值时，ICT组和直接PTCA组之间未发现显著差异。然而，6小时内进行再灌注时的Y比值显著高于6小时后进行再灌注时的Y比值，并且在心脏事件后9小时内的再灌注时间与（100 - Y比值）的值之间发现显著正相关（r = 0.63，p < 0 .01）。
Y比值似乎对急性心肌梗死急性期心肌活力的定量评估有用。此外，尽早进行再灌注以改善心肌挽救似乎很重要。
