| Japanese |
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| Title | 救命救急センターにおける急性心筋梗塞症の評価 - アイソトープ法を用いた心機能の評価とウロキナーゼの治療効果について - |
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| Subtitle | 原著 |
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| Authors | 山崎純一*, 森下健*, 大沢秀文*, 青木りう子*, 内孝*, 河村康明*, 奥住一雄*, 武藤敏徳*, 若倉学*, 斉藤徹**, 上嶋権兵衛**, 佐々木康人*** |
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| Authors(kana) | |
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| Organization | *東邦大学医学部第一内科, **救命救急センター, ***放射線科 |
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| Journal | 核医学 |
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| Volume | 22 |
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| Number | 10 |
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| Page | 1495-1503 |
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| Year/Month | 1985/10 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」 救命救急センター内に設置したRI使用室で, 急性心筋梗塞症61例に対し核医学検査を施行し, 心機能測定とウロキナーゼ (UK) による治療効果の判定を行った. circumferential profile curveを用いて算出したTl-defect ratioとpeak-CPK値の間にr=0.578 (p<0.001) の相関が認められた. Tl-defect ratioと左室駆出率 (LVEF) との間にr=-0.674 (p<0.001) の逆相関が認められた. 前壁・中隔梗塞のLVEFは37.2±11.7%で下壁梗塞の53.3±8.7%に比べ, 有意 (p<0.001) に低値を示した. 右室駆出率 (RVEF) は下壁梗塞で36.5±6.5%で, 前壁梗塞の43.0±10.0%と比し有意 (p<0.02) に低値を示した. Tl-defectratioは前壁・中隔梗塞で3.36±1.97で下壁梗塞, 後壁梗塞に比べ有意 (p<0.001, p<0.05) の高値が認められた. UK (6時間以内投与) 群とコントロール群の間で, 前壁・中隔梗塞においてLVEFとTl-defectratioに有意差が認められた. しかし下壁梗塞では両群間に有意差は認められなかった. 同センター内での核医学検査は急性心筋梗塞の心機能, 治療効果や予後を知る上で有用であると思われる. |
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| Practice | 臨床医学：一般 |
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| Keywords | ICU, Urokinase, Tl-201 myocardial scintigraphy, Tc-99m HSA gated pool study, AMI |
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| English |
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| Title | The Evaluation of the Cardiac Function and the Effect of Urokinase Therapy in Patients with AMI in ICU |
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| Authors | Junichi YAMAZAKI*, Takeshi MORISHITA*, Hidefumi OHSAWA*, Ryuko AOKI*, Takashi UCHI*, Yasuaki KAWAMURA*, Ichio OKUZUMI*, Toshinori MUTO*, Manabu WAKAKURA*, Toru SAITO**, Gonbei KAMIJIMA**, Yasuhito SASAKI*** |
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| Authors(kana) | |
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| Organization | *First Department of Internal Medicine, **ICU, ***Department of Radiology, Toho University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 22 |
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| Number | 10 |
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| Page | 1495-1503 |
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| Year/Month | 1985/10 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] The cardiac function and the effect of therapy in patients with acute myocardial infarction (AMI) were assessed in 61 patients by analysis of Tl-scintigraphy and Tc-HSA gated pool study in our ICU. Nineteen of them were treated with intravenous Urokinase (UK) within 6 hours from onset. The other 36 patients without UK treatment served as a control group. Significant correlation was recognized between Tl-defect ratio calculated by the circumferential profile curve and peak-CPK levels with a correlation coefficient of 0.578. Significant correlation (r=-0.674) was found between Tl-defect ratio and LVEF. Cardiac function, Tl-defect ratio and peak-CPK levels were compared among patients with antero-septal AMI, inferior AMI and posterior AMI. Significant reductions of LVEF (37.2+-11.7%) were observed in anteroseptal AMI, while RVEF (43.0+-10.0%) showed significant decreases in inferior AMI. In addition, Tl-defect ratio (3.36+-1.97) and peak-CPK levels in antero-septal AMI were significant higher than those in inferior AMI and posterior AMI. The UK group showed a significant increase of LVEF as compared with the control group in patients with antero-septal AMI. In patients with inferior AMI, no significant differences were observed between UK and control group in LVEF, RVEF and Tl-defect ratio. We have demonstrated that a combination of Tl-scintigraphy and Tc-HSA gated pool study are useful techniques especially when performed 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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| Practice | Clinical medicine |
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| Keywords | ICU, Urokinase, Tl-201 myocardial scintigraphy, Tc-99m HSA gated pool study, AMI |
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