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目的：探讨大剂量硝酸甘油介入（大剂量硝充法）99mTc-MIBI心肌SPECT对存活心肌判定的价值。材料和方法：对44例大剂量硝充组和31例小剂量硝充组的心肌梗塞患者均行静息和硝充法心肌显像。采用9节段评分法对两次显像进行了比较。其中两组中分别有18例和17例于冠脉血管再通术（PTCA或CABG）后半年内再次复查了静息心肌显像并与术前比较。结果：大剂量硝充组静息心肌显像灌注异常节段为154个，硝充后有77个节段呈现了再分布，总再分布率为50．0％（77／154）；小剂量硝充组静息心肌显像灌注异常节段为110个，硝充后有35个节段呈现了再分布，总再分布率为31．8％（35／110）。大剂量和小剂量组中18例和17例PTCA和CABG患者术后静息心肌显像与硝充法心肌显像比较阳性符合率分别为85．7％和68．8％．预测准确率为对71．9％和50．9％。结论：大剂量硝酸甘油介入99Tc-MIBI心肌SPECT具有较高的存活心肌检出率和预测准确性。
OBJECTIVE: To investigate the value of 99mTc-MIBI myocardial SPECT with high-dose nitroglycerin intervention (high-dose nitrification) in the determination of viable myocardium. MATERIALS AND METHODS: Myocardial infarction was performed in 44 patients with high dose of nitrocellulose and 31 patients of low dose of nitrocellulose. The 9-segment scoring method was used to compare the two images. Resting myocardial imaging was reviewed again in 18 and 17 of the two groups, respectively, within six months after coronary revascularization (PTCA or CABG), compared with preoperative. Results: There were 154 segments of perfusion in resting myocardial perfusion imaging in high-dose nitroglycerin group and 77 segments in nitrofen post-reperfusion. The total re-distribution rate was 50.0% (77/154) There were 110 abnormal myocardial perfusion segments in the group of nitroglycerin, and 35 segments in the group of nitric supplements. The total redistribution rate was 31.8% (35/110). In 18 and 17 PTCA and CABG patients, the positive coincidence rates of resting myocardial perfusion imaging and myocardial perfusion imaging after myocardial infarction were 85.7% and 68.8% in the high-dose and low-dose groups, respectively. The forecast accuracy is 71.9% and 50.9%. CONCLUSION: High dose of nitroglycerin intervened in 99Tc-MIBI myocardial SPECT with high detection rate of surviving myocardium and predictive accuracy.