Niitsu N, Yamazaki J, Igarashi M, Umeda M, Morishita T
First Department of Internal Medicine, Toho University School of Medicine.
Kaku Igaku. 1994 Sep;31(9):1051-7.
In 29 patients who had been administrated adriamycin (ADR) for the treatment of hematopoietic malignancies, myocardial SPECT was performed 20 minutes and 4 hours after an intravenous dose of 123I-metaiodobenzylguanidine (MIBG). Findings of the myocardial SPECT were compared with the total dose of ADR, ejection fraction (EF) and left ventricular wall motion, as assessed by ultrasound echocardiography. The mean total dose of ADR was 329.3 mg/m2 (range, 150-550 mg/m2). 1) Although the cardiac function was normal, the washout rate (WR) of MIBG was high in 75% of the patients whose MIBG myocardial SPECT showed abnormality on ADR, suggesting the presence of adrenergic nerve disorder. 2) The total dose of ADR was significantly correlated with WR of MIBG (p < 0.001). Consequently, WR of MIBG may be an index which reflects adrenergic nerve disorder in the myocardium earlier than EF. 3) It was suggested that adrenergic nerve disorder was involved in pathogenesis of myocardial complications associated with ADR administration. In summary, MIBG myocardial SPECT could be a useful test for determining a dosage regimen of ADR therapy of individual patients.
在29例接受阿霉素（ADR）治疗造血系统恶性肿瘤的患者中，静脉注射123I-间碘苄胍（MIBG）后20分钟和4小时进行心肌单光子发射计算机断层扫描（SPECT）。将心肌SPECT的结果与ADR的总剂量、通过超声心动图评估的射血分数（EF）和左心室壁运动进行比较。ADR的平均总剂量为329.3mg/m²（范围为150 - 550mg/m²）。1）尽管心功能正常，但在MIBG心肌SPECT显示ADR异常的患者中，75%的患者MIBG洗脱率（WR）较高，提示存在肾上腺素能神经紊乱。2）ADR的总剂量与MIBG的WR显著相关（p < 0.001）。因此，MIBG的WR可能是一个比EF更早反映心肌肾上腺素能神经紊乱的指标。3）提示肾上腺素能神经紊乱参与了与ADR给药相关的心肌并发症的发病机制。总之，MIBG心肌SPECT可能是确定个体患者ADR治疗剂量方案的有用检查。
