CAJ | 학술논문

目的研究长期进行大运动量体育锻炼的飞行员18F-脱氧葡萄糖(18F-FDG)心肌灌注显像的特点.方法 27 例无心血管病、糖尿病病史的长期进行大运动量锻炼的男性飞行员作为受枪者,分为受检当日早餐禁食(17例)和早餐予以谷物餐(10例)两组.每名受检者都在静息和蹬车运动达到次极最心率要求下进行2次99Tcm-甲氧基已乙腈(99Tcm-MIBI)和18F-FDG双核素心肌显像(共54例次),2次检查分别安排在相邻的2 d.然后对每名受检者进行运动与静息状态下心肌灌注显像进行视觉对比,判断是否存在心肌缺血.再采用17节段模型视觉半定量法对其心肌代谢显像结果进行分析.结果全部受检者蹬车运动都达到次极量心率(195-年龄),全部受检者的运动与静息99Tcm-MIBI心肌灌注显像对比后皆未发现心肌缺血.视觉定性分析,早餐禁食组共有4例次18F-FDGPET显像失败,不禁食组有1例次18F-FDG PET显像失败,差异无统计学意义.经17节段视觉半定量分析,在所有节段早餐禁食与否对运动和静息状态18F-FDG心肌代谢显像评分的影响差异均无统计学意义;在早餐禁食组,运动与静态的18F-FDG心肌代谢显像评分在6个节段差异有统计学意义;在不禁食组,3个节段的18F-FDG心肌代谢显像运动高于静息状态,差异具有统计学意义,其他节段无统计学差异.结论长期大运动最锻炼的受检者即使不接受保证心肌代谢处于糖负荷的措施也能获得完整清晰的18F-FDG心肌代谢显像.长期锻炼可能提高心肌对于葡萄糖代谢的利用率,并进而提高心肌代谢的氧利用率.长期锻炼可直接提高心肌对于缺血缺氧的耐受能力.
목적 연구장기진행대운동량체육단련적비행원18F-탈양포도당(18F-FDG)심기관주현상적특점.방법 27 례무심혈관병、당뇨병병사적장기진행대운동량단련적남성비행원작위수창자,분위수검당일조찬금식(17례)화조찬여이곡물찬(10례)량조.매명수검자도재정식화등차운동체도차겁최심솔요구하진행2차99Tcm-갑양기이을정(99Tcm-MIBI)화18F-FDG쌍핵소심기현상(공54례차),2차검사분별안배재상린적2 d.연후대매명수검자진행운동여정식상태하심기관주현상진행시각대비,판단시부존재심기결혈.재채용17절단모형시각반정량법대기심기대사현상결과 진행분석.결과 전부수검자등차운동도체도차겁량심솔(195-년령),전부수검자적운동여정식99Tcm-MIBI심기관주현상대비후개미발현심기결혈.시각정성분석,조찬금식조공유4례차18F-FDGPET현상실패,불금식조유1례차18F-FDG PET현상실패,차이무통계학의의.경17절단시각반정량분석,재소유절단조찬금식여부대운동화정식상태18F-FDG심기대사현상평분적영향차이균무통계학의의;재조찬금식조,운동여정태적18F-FDG심기대사현상평분재6개절단차이유통계학의의;재불금식조,3개절단적18F-FDG심기대사현상운동고우정식상태,차이구유통계학의의,기타절단무통계학차이.결론 장기대운동최단련적수검자즉사불접수보증심기대사처우당부하적조시야능획득완정청석적18F-FDG심기대사현상.장기단련가능제고심기대우포도당대사적이용솔,병진이제고심기대사적양이용솔.장기단련가직접제고심기대우결혈결양적내수능력.
Objective To evaluate the characteristics of myocardial 18F-FDG imaging in pilots with regular aerobic exercise training. Methods Twenty seven healthy male pilots with regular aerobic exercise training were included in this study. The subjects were divided into fasting(n=17) or non-fasting group (n=10). Fluorine-18-labeled deoxyglucose and Tc-99m-sestamibi dual-nuclide myocardial imaging were obtained at rest and at target heart rate during bicycle ergometer test. The exercise and rest myocardial perfusion imaging were analyzed for myocardial ischemia presence. The myocardial metabolism imaging was analyzed with the visual semi-quantitative analyses model of seventeen segments. Results The secondary-extreme heart rate (195-age) was achieved in all subjects. There was no myocardial ischemia in all perfusion imaging. In the visual qualitative analyses, four myocardial metabolism imaging failed in the fasting group while one failed in the non-fasting group (P > 0.05 ). In the visual semi-quantitative analyses,myocardial metabolism imaging scores at rest or exercise in all segments were similar between two groups (P>0.05). In the fasting group, the myocardial metabolism imaging scores during exercise were significantly higher than those at rest in 6 segments (P < 0.05 ). In the non-fasting group, the scores of 3 exercise myocardial metabolism imaging were significantly higher than those at rest ( P < 0.05). Conclusion Satisfactory high-quality myocardial metabolism imaging could be obtained at fasting and exercise situations in subjects with regular aerobic exercise.