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用锝-99m葡庚糖酸盐对实验性心肌梗死进行早期定量:闪烁显像和解剖学研究。

Early quantification of experimental myocardial infarction with technetium-99m glucoheptonate: scintigraphic and anatomic studies.

作者信息

Alonso D R, Jacobstein J G, Cipriano P R, Roberts A J, Alonso M L, Kline S A, Campo E, Pavlick C

出版信息

Am J Cardiol. 1978 Aug;42(2):251-8. doi: 10.1016/0002-9149(78)90907-4.

Abstract

Recent advances in understanding of the pathophysiology of myocardial necrosis indicate the need for a noninvasive method that will allow detection and quantification of infarcts in the first few hours after the onset of infarction. Myocardial infarct scintigraphy using technetium-99m glucoheptonate is capable of detecting infarction in dogs and man within 4 to 6 hours of onset. Studies were performed in 45 dogs with acute myocardial infarction: 28 with with an anterior infarct, 5 with an inferior infarct, 6 with an anterior infarct studied after infusion of mannitol and 6 with ligation of the left anterior descending coronary coronary artery and reperfusion of the ischemic area. The dogs were given 20 m Ci of technetium-99m glucoheptonate 1 hour after coronary occlusion, subjected to imaging 5 to 9 hours later and then killed. The experiments revealed that (1) scintigraphic infarct size correlated with infarct weight for anterior (r = 0.85) and inferior (r = 0.88) infarcts; (2) technetium-99m glucoheptonate also concentrated in a rim of myocardium around the infarct that probably represented the ischemic zone; and (3) technetium-99m glucoheptonate uptake by infarcted myocardium could be greatly increased with mannitol and reperfusion.

摘要

对心肌坏死病理生理学认识的最新进展表明,需要一种非侵入性方法,以便在心肌梗死发生后的最初几个小时内检测和量化梗死灶。使用锝-99m葡庚糖酸盐进行心肌梗死闪烁扫描能够在发病后4至6小时内检测出犬和人的心肌梗死。对45只急性心肌梗死犬进行了研究:28只患有前壁梗死,5只患有下壁梗死,6只在前壁梗死犬输注甘露醇后进行研究,6只进行左前降支冠状动脉结扎并对缺血区域进行再灌注。在冠状动脉闭塞1小时后给犬注射20毫居里的锝-99m葡庚糖酸盐,5至9小时后进行成像,然后处死。实验表明:(1)闪烁扫描梗死灶大小与前壁梗死(r = 0.85)和下壁梗死(r = 0.88)的梗死重量相关;(2)锝-99m葡庚糖酸盐也聚集在梗死灶周围的心肌边缘,这可能代表缺血区;(3)使用甘露醇和再灌注可大大增加梗死心肌对锝-99m葡庚糖酸盐的摄取。

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