用99m锝标记红细胞（99mTc-RBC）和99m锝-二乙三胺五乙酸（99mTc-DTPA）测量的血管外肺水在左心衰竭时增加。

Extravascular lung water measured with 99mTc-RBC and 99mTc-DTPA is increased in left-sided heart failure.

作者信息

Nawada M, Gotoh K, Yagi Y, Ohshima S, Yamamoto N, Deguchi F, Sawa T, Tanaka H, Yamaguchi M, Uemura H

机构信息

Second Department of Internal Medicine, Gifu University School of Medicine, Japan.

出版信息

Ann Nucl Med. 1993 May;7(2):87-95. doi: 10.1007/BF03164573.

DOI:10.1007/BF03164573

PMID:8318352

Abstract

Extravascular lung water (EVLW) was quantitatively measured in 81 patients consisting of 10 subjects with normal cardiac function and 71 patients with left-sided heart diseases, using 99mTc-RBC as a non-diffusible indicator and 99mTc-DTPA as a diffusible indicator in the equilibrium phase. EVLW averaged 3.0 +/- 1.4 (ml/kg, mean +/- SD) in subjects with normal cardiac function (n = 10), 4.3 +/- 1.7 in New York Heart Association functional class I patients (n = 30), 4.8 +/- 2.4 in NYHA functional class II patients (n = 33) and 9.4 +/- 5.4 in NYHA functional class III (n = 8) patients. EVLW was greater in NYHA class III than in normal controls or NYHA classes I or II (p < 0.01). Lung thermal volume (LTV) was also measured in 31 of the 81 patients using a double indicator dilution technique with sodium and heat. LTV averaged 6.0 +/- 1.2 (ml/kg) in normal subjects (n = 4), 8.6 +/- 2.0 in NYHA functional class I patients (n = 11), 9.7 +/- 3.0 in NYHA functional class II patients (n = 13), and 15.9 +/- 8.2 in NYHA functional class III patients (n = 3). The correlation between EVLW and LTV was significant (EVLW = 0.79 x LTV - 72.8, r = 0.80, p < 0.01). There were significant differences in EVLW/LTV ratio between NYHA class III (0.93 +/- 0.16) and NYHA class I (0.62 +/- 0.22). Thus, it was shown that EVLW was increased in left-sided heart failure and that LTV overestimated the EVLW.

摘要

采用99mTc - RBC作为非扩散指示剂、99mTc - DTPA作为平衡期扩散指示剂，对81例患者进行血管外肺水（EVLW）的定量测量，其中包括10例心功能正常的受试者和71例左侧心脏病患者。心功能正常的受试者（n = 10）的EVLW平均为3.0±1.4（ml/kg，均值±标准差），纽约心脏协会（NYHA）心功能I级患者（n = 30）为4.3±1.7，NYHA心功能II级患者（n = 33）为4.8±2.4，NYHA心功能III级患者（n = 8）为9.4±5.4。NYHA心功能III级患者的EVLW高于正常对照组或NYHA心功能I级或II级患者（p < 0.01）。还采用钠和热双指示剂稀释技术对81例患者中的31例进行了肺热容积（LTV）测量。正常受试者（n = 4）的LTV平均为6.0±1.2（ml/kg），NYHA心功能I级患者（n = 11）为8.6±2.0，NYHA心功能II级患者（n = 13）为9.7±3.0，NYHA心功能III级患者（n = 3）为15.9±8.2。EVLW与LTV之间的相关性显著（EVLW = 0.79×LTV - 72.8，r = 0.80，p < 0.01）。NYHA心功能III级（0.93±0.16）与NYHA心功能I级（0.62±0.22）之间的EVLW/LTV比值存在显著差异。因此，研究表明左侧心力衰竭时EVLW增加，且LTV高估了EVLW。