静脉滴注硝酸异山梨酯抗心肌缺血作用的量化评价

doi:教育部留学回国人员启动基金资助课题（2005

静脉滴注硝酸异山梨酯抗心肌缺血作用的量化评价

孟繁波¹，贾杰²，徐文贵³，孙平辉⁴，郭金锐^△，杨萍¹，王文志¹

1. 吉林大学中日联谊医院心血管内科，吉林长春130033；2. 吉林大学中日联谊医院电诊科，吉林长春130033；3. 天津市肿瘤医院PET CT中心，天津300060;4. 吉林大学公共卫生学院统计流行病学教研室,吉林长春130021

收稿日期:2005-07-25 修回日期:1900-01-01 出版日期:2006-05-28 发布日期:2006-05-28

Quantitative evaluation of anti-ischemic effectof isosorbide dinitrate for intravenous

MENG Fan-bo¹,JIA Jie²,XU Wen-gui³,SUN Ping-hui⁴,GUO Jin-rui^△, YANG Ping¹, WANG Wen-zhi¹

1. Department of Cardiology，China-Japan Union Hospital,Jilin University, Changchun 130033, China;2. Department of Ultrasonic Diagnosis， China-Japan Union Hospital, Jilin University, Changchun 130033, China; 3. Department of PET，Tumor Hospital of Tianjin, Tianjian 300060, China;4. Department of Epidemiology and Statistics， School of Public Health,Jilin University, Changchun 130021, China

Received:2005-07-25 Revised:1900-01-01 Online:2006-05-28 Published:2006-05-28

摘要/Abstract

摘要： 目的：量化评价静脉滴注硝酸异山梨酯（ISDN）的抗心肌缺血作用。方法：36例冠心病患者随机分为3组，分别在滴注ISDN 30（Ⅰ组）、60（Ⅱ组）和90 min（ Ⅲ组）的3个时间点，利用Tc-MIBI心肌灌注SPECT断层显像形成展开图，测定患者给药前后缺血心肌面积占整个左心室面积百分比的变化及心电图的改变。结果：Ⅰ组，65%阈值基线值（33.01±5.35）%，ISDN静脉滴注后（28.93±5.20）% （P<0.05）；55%阈值基线值（22.06±5.58）% ，ISDN静脉滴注后（19.60±4.07）% （Ｐ<0.05）；缺血ST段片段总数，基线为60段，ISDN静脉滴注后51段。Ⅱ组，65% 阈值基线值（29.29±5.08）%，ISDN静脉滴注后（20.81±4.16%）（P<0.001）；55%阈值基线值（21.29±5.49）%，ISDN静脉滴注后（17.52±5.59）%（P<0.001）；缺血ST段片段总数，基线为58段，ISDN静脉滴注后47段。Ⅲ组，65%阈值基线值(3 2.87±6.46)%，ISDN静脉滴注后(20.81±4.16)%（P<0.001）；55%阈值基线值（18.42±5.17）%，ISDN静脉滴注后（14.18±3.61）%（P<0.001）；缺血ST段片段总数，基线为64段，ISDN静脉滴注后41段。结论：Tc-MIBI心肌灌注SPECT断层显像形成展开图可以作为量化评价硝酸异山梨酯抗心肌作用的方法，硝酸异山梨酯可以提高冠脉血流量，改善心肌灌注。

关键词: 硝酸, 体层摄影术, 发射型计算机, 单光子, 展开图, 锝甲氧基异丁基异腈, 心肌缺血

Abstract: Objective To evaluate the anti-ischemic effect of isosorbide dinitrate (ISDN) quantitatively. Methods 36 patients were divided into three group according to the different time points after the start of ISDN infused intravenously：groupⅠ (30 min), group Ⅱ(60 min), group Ⅲ(150 min).Tc-MIBI myocardial perfusion SPECT images was used to evaluate directly the anti-ischemic effect of ISDN on 36 patients with coronary heart disease. The changes in the percentage of ischemia area in entire left ventricular area and ECG were determined by the unfolded surface mapping before and after ISDN infusion. Results Tc-MIBI myocardial perfusion SPECT images were acquired, and reconstruction of the bull′s eye map and unfolded surface mapping were performed according to the dates of tomography images. In groupⅠ: at the 65% threshold value, (33.01±5.35)% at baseline,(28.9±5.23)% after ISDN was infused (P<0.05); at the 55% threshold value, (22.06±5.58)% at baseline,(19.60±4.07)% after ISDN was infused (P<0.05); the sum of ischemia ST segments was 60 at baseline, 51 after ISDN was infused. In group Ⅱ:at the 65% threshold value, (29.20±5.08)% at baseline, (20.81±4.16)% after ISDN was infused (P<0.001); at the 55% threshold value, (21.2±5.49)% at baseline,(17.52±5.59)% after ISDN was infused (P<0.001) ; the sum of ischemia ST segments was 58 at baseline, 47 after ISDN was infused. In group Ⅲ: at the 65% threshold value, (32.87±6.46)% at baseline, (20.81±4.16)% after ISDN was infused (P<0.001); at the 55% threshold value, (18.42±5.17)% at baseline,(14.18±3.61)% after ISDN was infused (P<0.001) ; the sum of ischemia ST segments was 64 at baseline, 41 after ISDN was infused. Conclusion The unfolded surface mapping of Tc-MIBI myocardial perfusion image can be used as a method of quantitative evaluation of the anti-ischemic effect of drugs and ISDN iv drip can improve the blood flow in myocardium and myocardial perfusion.

Key words: tomography, emission computed , single photo, unfolded surface mapping, technetium Tc99m sestamibi, myocardial ischemia

中图分类号:

R542.2

孟繁波，贾杰，徐文贵，孙平辉，郭金锐，杨萍，王文志. 静脉滴注硝酸异山梨酯抗心肌缺血作用的量化评价[J]. J4, 2006, 32(3): 454-457.

MENG Fan-bo,JIA Jie,XU Wen-gui,SUN Ping-hui,GUO Jin-rui, YANG Ping, WANG Wen-zhi. Quantitative evaluation of anti-ischemic effectof isosorbide dinitrate for intravenous[J]. J4, 2006, 32(3): 454-457.

[1]	倪红霞, 王春梅. 白芷总香豆素联合白芷挥发油对大鼠偏头痛的预防作用及其机制[J]. 吉林大学学报(医学版), 2018, 44(03): 487-492.
[2]	赵庆斌, 刘丹丹, 李超. 糖尿病兔心肌缺血早期心肌细胞超微结构和心肌组织中肿瘤坏死因子α表达水平及其意义[J]. 吉林大学学报(医学版), 2017, 43(03): 463-467.
[3]	庞磊, 孙小婷, 魏骐, 李志文, 董愫, 麻海春. 前列腺素受体EP4在心肌肥厚和心肌缺血/再灌注损伤中作用的研究进展[J]. 吉林大学学报(医学版), 2016, 42(06): 1249-1253.
[4]	刘洋, 程欣, 石希敏, 党永红, 刘宇, 刘小丽. ¹⁸FDGPET/CT在皮肌炎/多发性肌炎伴恶性肿瘤诊断中的应用[J]. 吉林大学学报(医学版), 2016, 42(03): 587-590.
[5]	王巍, 张锋磊, 周丽丽, 王红, 张晓平, 史海莲. 128排CT冠状动脉造影前硝酸甘油最佳含服时间的动态观察及其意义[J]. 吉林大学学报(医学版), 2016, 42(02): 375-379.
[6]	黄宇欣, 高海成, 刘凯, 苗春生. 盐酸异丙肾上腺素诱发大鼠心肌缺血性纤维化后肝脏损伤的拉曼光谱分析[J]. 吉林大学学报(医学版), 2015, 41(03): 584-587.
[7]	吴敏, 赵红光, 关锋, 萨日, 林承赫. ¹⁸F-FDG PET/CT显像在原发性中枢神经系统淋巴瘤诊断中的应用[J]. 吉林大学学报(医学版), 2015, 41(02): 401-404.
[8]	左晓军，倪冠英. ¹⁸F-FDG PET-CT在非小细胞肺癌TNM分期中的应用及其临床意义[J]. 吉林大学学报(医学版), 2014, 40(06): 1293-1296.
[9]	王杰，曾勇明，彭刚，郁仁强，孙静坤，金瑞. 胸部低剂量CT扫描中迭代重建算法与滤波反投影算法肺结节检出率和准确性比较[J]. 吉林大学学报(医学版), 2014, 40(05): 1098-1103.
[10]	. 黄芪甲苷对大鼠心肌局部缺血再灌注损伤的改善作用及其对PI3K/Akt/mTOR信号通路的影响[J]. 吉林大学学报(医学版), 2014, 40(05): 991-996.
[11]	余帆，徐彤彤，吕祥威，佐妍，李静. 瘦素预处理对2型糖尿病大鼠心肌缺血再灌注损伤的保护作用[J]. 吉林大学学报(医学版), 2013, 39(6): 1219-1223.
[12]	谢海，赵建农，陈勇，周期，李艳. 每搏变异度和中心静脉压对肝叶切除术患者低血容量的诊断价值比较[J]. 吉林大学学报(医学版), 2013, 39(6): 1256-1260.
[13]	石博，黄可欣，叶保国，张艳，黄可敬. 阿托伐他汀预处理对大鼠心肌缺血再灌注后不同时间点心肌组织中HIF-α和VEGF表达的影响[J]. 吉林大学学报(医学版), 2013, 39(6): 1159-1163.
[14]	黄可欣, 石博, 叶保国, 宋雪松 . 阿托伐他汀对心肌缺血再灌注损伤大鼠心肌酶和心肌细胞凋亡的影响及其心肌保护作用机制[J]. 吉林大学学报(医学版), 2013, 39(5): 923-927.
[15]	张雪，陈萍，毕云枫，曲宁宁，刘琼，孙鑫泽. 木糖氧化产碱菌中亚硝酸盐还原酶基因的克隆与表达[J]. 吉林大学学报(医学版), 2013, 39(4): 690-693.