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长期,强烈的风险因素修改后,正子发射断层扫描对心肌 perfusion 异常的变化
K L Gould1, D Ornish, L Scherwitz
1Department of Medicine, University of Texas Medical School at Houston 77030, USA.
JAMA
|September 20, 1995
概括
包括饮食和运动在内的综合风险因素修改,在五年内显著改善了冠状动脉疾病患者的心肌输液异常. 定子发射断层扫描 (PET) 显示了这些改善,表明疾病回归.
科学领域:
- 心脏病学 心脏病学
- 核医学就是核医学.
- 预防性心脏病学预防性心脏病学
背景情况:
- 冠状动脉疾病 (CAD) 管理传统上侧重于抗风脉治疗.
- 生活方式干预越来越被认为具有改变CAD进展的潜力.
- 对心肌输液变化的客观量化对于评估治疗疗效至关重要.
研究的目的:
- 在CAD患者中经过五年密集风险因素修改后,使用正子发射断层扫描 (PET) 量化评估心肌 perfusion 异常的变化.
- 为了比较全面的生活方式干预计划与常规护理对冠状动脉疾病严重性的影响.
主要方法:
- 一项随机对照试验涉及35名患有CAD的患者,分为一个实验组 (n=20) 接受风险因素修改和一个控制组 (n=15) 接受通常护理.
- 风险因素的修改包括非常低脂肪的素食饮食,适度炼,压力管理和团体支持.
- 在基线和五年后进行定量冠状动脉造影和休息二皮里达摩尔PET扫描,并自动分析输液和狭窄严重程度.
主要成果:
- 与对照组相比,实验组在PET扫描上显示了心肌输液异常的大小和严重性的显著改善 (减少),对照组呈现恶化.
- 具体指标,包括左心室异常和活动减少的百分比,在干预组显著改善 (P=.02,P=.002).
- 由PET衍生的输液异常的变化与通过定量冠状动脉造影观察到的冠状动脉狭窄严重程度的变化相当或大于变化.
结论:
- 密集的风险因素修改与冠状动脉狭窄症的回归和心肌输液异常的显著改善有关.
- 二皮里达摩尔PET成像提供了一种非侵入性方法,通过评估综合冠状动脉流量容量来监测冠状动脉疾病的进展或回归.
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