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目的：探讨硝酸甘油（ＮＴＧ）介入９９ｍ锝—甲氧基异丁基异腈（９９ｍＴＣ－ＭＩＢＩ）心肌灌注显像评价存活心肌、指导经皮冠状动脉腔内成形术（ＰＴＣＡ），把握适应证及判定ＰＴＣＡ疗效的应用价值。 方法：对２３例行ＰＴＣＡ的急性心肌梗塞患者进行术前静息９９ｍＴＣ－ＭＩＢＩ心肌灌注显像、ＮＴＧ介入９９ｍＴＣ－ＭＩＢＩ心肌灌注显像和术后１周、２个月静息９９ｍＴＣ－ＭＩＢＩ心肌灌注显像，采用４点积分法半定量分析９９ｍＴＣ－ＭＩＢＩ的摄取。根据放射性异常程度不同将受累心肌节段分为心肌存活节段，部分心肌存活节段、心肌无存活节段。 结果：ＮＴＧ介入９９ｍＴｃ－ＭＩＢＩ心肌灌注显像评价存活心肌的阳性预测值、阴性预测值和准确度，它们分别为８５．０％、８８．５％和８４．９％。ＰＴＣＡ后心肌存活节段和部分心肌存活节段放射性异常积分明显降低，心肌无存活节段未见显著变化。 结论：ＮＴＧ介入９９ｍＴｃ－ＭＩＢＩ心肌灌注显像能显著提高存活心肌的检出率，对急性心肌梗塞血运重建术的疗效判定及指导临床适应证的选择具有较高的应用价值。
Objective: To investigate the effect of NTG on 99m Tc-MIBI myocardial perfusion imaging to evaluate viable myocardium and guide percutaneous transluminal coronary angioplasty (PTCA) Therapeutic value of the application. Methods: Thirty-three patients with acute myocardial infarction who underwent PTCA underwent 99mTC-MIBI myocardial perfusion imaging, NTG interventional 99mTC-MIBI myocardial perfusion imaging and postoperative one week, and resting 99mTC-MIBI myocardial perfusion Imaging, semi-quantitative analysis of 99mTC-MIBI uptake by 4 point integration. According to the different degree of radiation abnormalities, the involved myocardial segments are divided into myocardial viable segments, some myocardial viable segments and non-viable myocardial segments. RESULTS: The NTG interventional 99mTc-MIBI myocardial perfusion imaging evaluated the positive predictive value, negative predictive value and accuracy of viable myocardium, which were 85.0%, 88.5% and 84.9%, respectively. After PTCA, the radioactive abnormality scores of the surviving segments of myocardium and some of the surviving segments of myocardium were significantly decreased, and no significant changes were found in the non-viable segments of myocardium. Conclusion: NTG intervention with 99mTc-MIBI myocardial perfusion imaging can significantly improve the detection rate of viable myocardium. It is of high value in judging the curative effect of acute myocardial infarction revascularization and guiding clinical indications.