【摘要】 目的 :利用小剂量 Dob介入 99m Tc- MIBI(MB- Dob)和 2 0 1 Tl再注射显像 (Tl- PR)、小剂量 Dob介入 2 0 1 Tl再注射显像 (Tl- Dob)的对比研究 ,探讨小剂量 Dob介入对提高存活心肌检出率的作用。方法 :6 9例 OMI患者分二组在 14d内做了 Tl- PR、Tl- Dob在 7d内做了潘生丁负荷 99m Tc- MIBI显像、MB- Dob。Tl- Dob于 4h时静脉点滴Dob,从 5 μg/ kg· min- 1开始 ,5 m in后增至 10 μg/ kg· min- 1此时再注射 2 0 1 Tl40 MB并继续维持 5 m in;MB- Dob静脉点滴 Dob过程同 Tl- Dob,在 Dob浓度增至 10 μg/ kg· min- 1时 ,嘱患者舌下含服硝酸甘油 1mg,5 m in后静脉推注 99mTc- MIBI 740 MBq。结果 :MB- Dob心肌灌注明显改善节段率为 46 .7% ,Tl- PR为 32 .2 % ,Tl- Dob为 37.7% ,MB- Dob与 Tl- PR的心肌灌注明显改善节段数差异显著 ,与 Tl- Dob无显著差异 ,并且 MB- Dob与 Tl- PR心肌灌注明显改善节段的放射性摄取率增加值差异显著。结论 :MB- Dob较 Tl- PR可明显提高存活心肌的检出率 ,是一种安全、有效 ,易于推广的判断存活心肌的方法。更多还原

【Abstract】 Objective:We studied small dose dobutamine 99m Tc-MIBI myocardial imaging (MB-DOb) and compared with 201 Tl reinjected (Tl-PR) and small dose dobutamine 201 Tl reinjected myocardial imaging (Tl-Dob) for exploring the effect of small dose dobutamine myocardial imaging for the detection of viable myocardium.Method:The 69 patients were divide into two groups,one group the patients had been done Tl-PR and Tl-Dob within two weeks,another group had been done dipyridamole stress 99m Tc-MIBI imaging and MB-Dob within one week.In Tl-Dob, after first injecting 201 Tl 4 hours,we began to inject the dobutamine with 5μg/kg·min -1 and remained 5 min,then we increased the dobutamine concentration to 10μg/kg·min -1 ,at the same time we reinjected 201 Tl 40 MB and remained 5 min.So is MB-Dob for injecting dobutamine,but we let the patients have sublingual Nitroglycerin l mg at the beginning time of 10μg/kg·min -1 of dobutamine.Result:The radio of segmental activity improving after dobutamine of MB-Dob、Tl-PR and Tl-Dob was 46.7%,32.2% and 37.7% respectively.It has significant different between MB-Dob and Tl-PR for the detection of viable myocardium,and no different between MB-Dob and Tl-Dob.Conclusion:Compared with Tl-PR,the MB-Dob can increases the accuracy for the detection of myocardial viability,and small dose dobutamine 99m Tc-MIBI myocardial imaging is a safe,effective method for the detection of viable myocardium.更多还原