CAJ | 학술논문

目的对比99Tcm-替曲膦(TF)和99Tcm-MIBI G-MPI的左室心肌灌注及左室心功能参数结果,探讨99 Tcm-TF能否作为临床G-MPI常规显像剂.方法 99Tcm标记TF和MIBI并进行放化纯测定.选取2011年12月至2012年5月间既往健康、排除严重心律不齐及临床拟诊为心肌炎、心肌病的112例受试者(研究经医院伦理委员会批准,患者签署知情同意书),采用简单随机抽样法将其随机分成2组,分别行一日法99Tcm-TF(47例,运动负荷状态下注射显像剂370 MBq,静息状态下注射显像剂740 MBq)G-MPI和两日法99Tcm-MIBI(65例,注射剂量均为555 MBq)G-MPI,所有受试者均于1周内行CAG和UCG检查.利用Cedars定量门控SPECT(QGS)软件获得左室心功能参数,包括LVEF、EDV、ESV、峰充盈率(PFR)、峰射血率(PER)及相位标准差(SD).采用SPSS 17.0软件进行x2检验、两独立样本r检验、配对r检验及直线相关分析.结果 99 Tcm-TF和99Tcm-MIBI放化纯分别为(97.5±0.4)％和(99.1±0.2)％.与CAG结果对比,99Tcm-MIBI心肌灌注结果符合率为90.5％(57/63),99Tcm-TF为88.9％(40/45),两者差异无统计学意义(x2=0.389,P＞0.05).99Tcm-TF和99Tcm-MIBIG-MPI获得的左室心功能参数差异也无统计学意义[LVEF:(62.60±±13.56)％与(60.52±7.08)％,r=0.940;EDV:(103.31±17.29) ml与(98.52±19.37) ml,t=1.348;ESV:(41.73±12.69) ml与(46.05±10.81) ml,t=0.851;PER:(2.73±0.67) EDV/s与(2.61±1.04) EDV/s,t =0.725;PFR:(2.13±0.80) EDV/s与(2.07±1.09) EDV/s,t=0.339;相位SD:(5.58±4.16).与(5.97±4.64).,t=0.450,均P＞0.05].两者G-MPI获得的左室心功能参数与UCG结果差异无统计学意义[LVEF:(61.39±10.28)％与(62.13±8.51)％,t=0.991;EDV:(100.50±18.61) ml与(101.70±18.34) ml,t=1.806;ESV:(44.25±11.77) ml与(43.94±11.28)ml,t=0.658;均P＞0.05],且与UCG结果呈正相关(r=0.673、0.710和0.452,均P＜0.05).结论 99Tcm-TF可作为G-MPI显像剂常规用于临床,同时评价左室心肌灌注情况和左室功能.
목적 대비99Tcm-체곡련(TF)화99Tcm-MIBI G-MPI적좌실심기관주급좌실심공능삼수결과,탐토99 Tcm-TF능부작위림상G-MPI상규현상제.방법 99Tcm표기TF화MIBI병진행방화순측정.선취2011년12월지2012년5월간기왕건강、배제엄중심률불제급림상의진위심기염、심기병적112례수시자(연구경의원윤리위원회비준,환자첨서지정동의서),채용간단수궤추양법장기수궤분성2조,분별행일일법99Tcm-TF(47례,운동부하상태하주사현상제370 MBq,정식상태하주사현상제740 MBq)G-MPI화량일법99Tcm-MIBI(65례,주사제량균위555 MBq)G-MPI,소유수시자균우1주내행CAG화UCG검사.이용Cedars정량문공SPECT(QGS)연건획득좌실심공능삼수,포괄LVEF、EDV、ESV、봉충영솔(PFR)、봉사혈솔(PER)급상위표준차(SD).채용SPSS 17.0연건진행x2검험、량독립양본r검험、배대r검험급직선상관분석.결과 99 Tcm-TF화99Tcm-MIBI방화순분별위(97.5±0.4)％화(99.1±0.2)％.여CAG결과대비,99Tcm-MIBI심기관주결과부합솔위90.5％(57/63),99Tcm-TF위88.9％(40/45),량자차이무통계학의의(x2=0.389,P＞0.05).99Tcm-TF화99Tcm-MIBIG-MPI획득적좌실심공능삼수차이야무통계학의의[LVEF:(62.60±±13.56)％여(60.52±7.08)％,r=0.940;EDV:(103.31±17.29) ml여(98.52±19.37) ml,t=1.348;ESV:(41.73±12.69) ml여(46.05±10.81) ml,t=0.851;PER:(2.73±0.67) EDV/s여(2.61±1.04) EDV/s,t =0.725;PFR:(2.13±0.80) EDV/s여(2.07±1.09) EDV/s,t=0.339;상위SD:(5.58±4.16).여(5.97±4.64).,t=0.450,균P＞0.05].량자G-MPI획득적좌실심공능삼수여UCG결과차이무통계학의의[LVEF:(61.39±10.28)％여(62.13±8.51)％,t=0.991;EDV:(100.50±18.61) ml여(101.70±18.34) ml,t=1.806;ESV:(44.25±11.77) ml여(43.94±11.28)ml,t=0.658;균P＞0.05],차여UCG결과정정상관(r=0.673、0.710화0.452,균P＜0.05).결론 99Tcm-TF가작위G-MPI현상제상규용우림상,동시평개좌실심기관주정황화좌실공능.
Objective Tocompare the results of 99Tcm-tetrofosmin (TF) and 99Tcm-MIBI G-MPI in evaluating left ventricular myocardial perfusion and other functional parameters.Methods TF and MIBI were both labeled by 99Tcm and the radiochemical purities were tested.During December 2011 to May 2012,112 patients who had examinations of CAG and echocardiograph in one week after G-MPI were divided into 99Tcm-TF group (47 patients) and 99Tcm-MIBI group (65 patients) by simple random sampling.Patients who suffered from severe arrhythmia,clinically suspicious of mycarditis or cardiomyopathy were excluded.The research was approvel by the ethics committee,and all patients signed informed consents.One-day 99Tcm-TF G-MPI and two-day 99Tcm-MIBI G-MPI were performed.The left ventricular functional parameters were acquired automatically by Cedars quantitative gated SPECT (QGS) software,including LVEF,EDV,ESV,peak filling rate (PFR),peak ejection rate (PER) and phase standard difference (SD).The data were analyzed using x2 test,two-sample t test,paired t test and linear correlation analysis by SPSS 17.0.Results The radiochemical purities of 99Tcm-TF and 99Tcm-MIBI were (97.5±0.4) ％ and (99.1±0.2) ％ respectively.The coincidence rates of 99Tcm-TF and 99Tcm-MIBI G-MPI with CAG were 88.9％ (40/45) and 90.5％ (57/63),respectively.There was no significant difference between G-MPI results of the two agents (x2 =0.389,P＞0.05).There was also no significant difference between left ventricular functional parameters of the two agents (LVEF:(62.60±13.56)％ vs (60.52±7.08)％,t=0.940; EDV:(103.3±17.29) ml vs (98.52±19.37) ml,t=1.348; ESV:(41.73±12.69) ml vs (46.05±10.81) ml,t=0.851; PER:(2.73±0.67)EDV/s vs (2.61±1.04) EDV/s,t=0.725; PFR:(2.13±0.80) EDV/s vs (2.07±1.09) EDV/s,t=0.339;phase SD:(5.58±4.16)° vs (5.97±4.64)°,t=0.450; all P＞0.05).There was no significant difference between left ventricular functional parameters by G-MPI and UCG (LVEF:(61.39± 10.28) ％ vs (62.13±8.51) ％,t=0.991 ; EDV:(100.50±18.61) ml vs (101.70±18.34) ml,t=1.806; ESV:(44.25±11.77) ml vs (43.94±11.28) ml,t=0.658; all P＞0.05).LVEF,EDV,ESV by G-MPI correlated with the results of UCG (r=0.673,0.710,0.452,all P＜0.05).Conclusion 99Tcm-TF can also be used as a G-MPI agent to evaluate left ventricular myocardial perfusion and other functional parameters.