核素心肌灌注显像评价围产期心肌病的治疗效果

Evaluating treatment effectiveness of peripartum cardiomyopathy by 99mTc-MIBI SPE MPI

摘要:

目的：利用核素心肌灌注显像观察围产期心肌病（perfusion of peripartum cardiomyopathy，PPCM）治疗前与治疗后左室形态大小及左室各壁心肌血流灌注的变化。方法：27例 PPCM患者，女性，年龄19~38岁。对其行控制心力衰竭及防止心室重构治疗，分别于治疗前、治疗后1月[（29.41±2.95） d]行静息心肌灌注显像；其中11例患者进行了6月[（6.31±0.84）月]随访复查。将左室分为17节段进行评分，采用半定量分析方法评价治疗前、后左室大小，放射性分布稀疏缺损范围及左室各节段评分的变化。结果：治疗后早期与治疗前心肌灌注显像相比，23例患者（85%）左心室缩小，放射性分布稀疏缺损范围缩小（P=0.001），心肌各节段（除前间壁基底段及后间壁基底段外）评分增加（Pmax=0.024）；治疗后半年与治疗后早期比较，其中7例患者（64%）左心室大小恢复正常，放射性分布稀疏缺损范围进一步缩小（P=0.009），放射性分布稀疏缺损节段评分进一步增加（Pmax=0.048）。结论：99mTc-MIBI SPE MPI心肌灌注显像可用于评价PPCM的治疗效果。

Abstract:

Objective：To observe the morphology of left ventricle and changes in myocardial perfusion of peripartum cardiomyopathy （PPCM） before and after treatment by 99mTc-MIBI SPE MPI. Methods：Twenty-seven female patients with PPCM averaged 19-38 year-old were enrolled. Treatment preventing cardiac failure and ventricular remodeling were performed on them. 99mTc-MIBI SPE MPI was applied at one month（（29.41±2.95） d） after the treatment. Eleven patients were followed-up for six months（（6.31±0.84）months）. Left ventricle was divided into 17 segments and semi quantitative assessment was performed to evaluate the morphology of left ventri－cle，perfusion defect range and changes in left ventricular segmental score before and after the treatment. Results：Left ventricular size was decreased in 23 patients（85%），perfusion defect range was decreased（P=0.001） and myocardial perfusion was increased in all left ventricular segments except basal segment of anterior wall and basal segment of posterior wall（Pmax=0.024） at early stage of treat－ment compared with those before treatment. Left ventricular size was normal in 7 patients（64%），perfusion defect range was further decreased in 11 patients（P=0.009） and myocardial perfusion was further increased（Pmax=0.048） after 6 months’ treatment compared with those before treatment. Conclusion：99mTc-MIBI SPE MPI can be used to assess treatment in patients with peripartum cardiomy－opathy.