急性心筋梗塞症の心機能と治療効果の評価　　核医学検査を用いての急性期および慢性期での比較

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  • The evaluation of cardiac function and the effect of therapy in acute myocardial infarction. Comparison by radio nuclide method in acute and chronic phase.
  • キュウセイ シンキン コウソクショウ ノ シン キノウ ト チリョウ コウカ
  • —Comparison by Radio Nuclide Method in Acute and Chronic Phase—
  • ―核医学検査を用いての急性期および慢性期での比較―

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The cardiac function and the effect of therapy in patients with acute myocardial infarction (AMI) were assessed in over 100 patients by analysis of 201Tl-scintigraphy and 99mTc-gated pool study in our ICU. The cardiac function and 201Tl-defect ratio were compared with the results obtained in chronic phase. Sixteen of them were treated with intravenous urokinase (UK) within 6 hours from onset. The other 18 patients without UK treatment served as a control group. Significant correlation was recognized between 201Tl-defect ratio and peak-CPK levels, peak-GOT levels, peak-LDH levels. Significant correlation (γ=-0.655, γ=-0.713) were found between 201Tl-defect ratio and LVEF in acute and chronic phase. The UK group showed a significant increase of LVEF as compared with the control group in patients with antero-septal (A/S) AMI. In inferior (INF) AMI, no significant differences were observed UK and control group in LVEF, RVEF and 201Tl-defect ratio. In chronic phase, improvements of LVEF and 201Tl-defect ratio were observed in patients with A/S AMI. But no significant differences of LVEF, RVEF and 201Tl-defect ratio were observed in A/S AMI in acute and chronic phase. The UK group showed a significant increase of LVEF (50.1%) as compared with the control group of A/S AMI in chronic phase. We have demonstrated that a combination of 201Tl-seintigraphy and 99mTe-gated pool study are useful techniques in ICU, to evaluate the cardiac function and the effect of thrombolysis therapy and thus greatly contribute to the primary care of AMI cases.

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