Cittanti C, Colamussi P, Giganti M, Orlandi C, Uccelli L, Manfrini S, Azzena G, Piffanelli A
Department of Nuclear Medicine, University of Ferrara, Italy.
Eur J Nucl Med. 1997 Jul;24(7):762-6. doi: 10.1007/BF00879664.
Carnitine derivatives, such as propionyl-l-carnitine (PLC), have been shown to improve walking distance in patients with obstructive peripheral artery disease (PAOD). The aim of this study was to ascertain whether technetium-99m sestamibi leg scintigraphy may be a useful tool in the evaluation of changes in skeletal muscle metabolism induced by chronic therapy with PLC. Twenty patients with clinical and instrumental evidence of PAOD were randomly assigned to a 3-month period of therapy with either PLC or placebo. Rest 99mTc-sestamibi leg scintigraphy and echo-Doppler sonography were performed on all subjects immediately before and upon completion of the treatment period. At the end of the protocol the following results were observed in patients who underwent PLC administration: (a) a significant increase in both thigh and calf 99mTc-sestamibi uptake, in comparison with baseline values (P<0.001); (b) the absence of statistically significant modifications of Doppler blood flow indices of the lower limbs. In conclusion, after chronic administration of PLC, a significant increment in skeletal muscle uptake of 99mTc-sestamibi was demonstrated without any apparent change in regional blood flow. This fact, if proven in further studies, may suggest a role for this tracer as a non-invasive probe of tissue bioenergetics.
肉碱衍生物，如丙酰-L-肉碱（PLC），已被证明可改善阻塞性外周动脉疾病（PAOD）患者的步行距离。本研究的目的是确定锝-99m 甲氧基异丁基异腈腿部闪烁扫描是否可能是评估 PLC 长期治疗引起的骨骼肌代谢变化的有用工具。20 例有 PAOD 临床和影像学证据的患者被随机分为两组，分别接受为期 3 个月的 PLC 治疗或安慰剂治疗。在治疗期开始前及结束时，对所有受试者进行静息状态下的 99mTc-甲氧基异丁基异腈腿部闪烁扫描和超声多普勒检查。在完成治疗方案后，对接受 PLC 治疗的患者观察到以下结果：（a）与基线值相比，大腿和小腿的 99mTc-甲氧基异丁基异腈摄取量均显著增加（P<0.001）；（b）下肢多普勒血流指数无统计学意义的改变。总之，长期给予 PLC 后，99mTc-甲氧基异丁基异腈在骨骼肌中的摄取量显著增加，而局部血流无明显变化。如果在进一步研究中得到证实，这一事实可能提示该示踪剂可作为组织生物能学的非侵入性探针发挥作用。
