西宁地区藏、汉族冠心病患者常见危险因素与冠脉病变程度的研究

目的：探讨低氧环境下西宁地区藏、汉族冠心病（CHD）危险因素的特点及冠状动脉病变特征。方法：选择西宁地区248例藏族冠心病组（ZGZ）患者和252例汉族冠心病组（HGZ）患者,比较两组冠心病危险因素（高血压、糖尿病、高脂血症、吸烟、冠心病家族史等）的差异性;分析两组冠心病生化指标（TC、TG、LDL-C、HDL-C、UA、FBG、TBIL、MPV、FIB）的区别,并探讨两组冠状动脉病变Gensini积分值特征。结果：西宁地区HGZ高血压、糖尿病、吸烟发生率均高于ZGZ;ZGZ家族史高于HGZ;藏、汉族冠心病患者血脂无统计学意义。HGZ患者LDL-C、UA、FBG、FIB均高于ZGZ（P〈0.01）;TBIL低于ZGZ（P〈0.01）。TC、TG、HDLC、MPV两组间比较无统计学差异（P〉0.05）。HGZ合并高血压、糖尿病、吸烟的冠状动脉Gensini积分值高于ZGZ（均P〈0.001）,合并高脂血症的冠状动脉Gensini积分值两者间无统计学差异（P〉0.05）,ZGZ并冠心病家族史的Gensini积分高于HGZ,（P〈0.05）。HGZ总体Gensini积分高于ZGZ,（P〈0.01）。结论：西宁地区藏、汉族冠心病患者的冠心病危险因素存在某些差别,冠心病生化指数和冠脉病变程度也不尽相同,这些差异可能与高原适应,遗传及生活习惯有关。     

冠心病患者多种危险因素与冠脉病变的相关性

目的探讨冠心病（CHD）患者多种心血管危险因素与冠脉病变特点的相关性。方法随机选择行冠脉造影术患者337例,以单因素分析心血管危险因素与冠脉病变的关系,采用多因素Logistic回归分析筛选CHD的独立相关危险因素。结果 （1）CHD组平均年龄、体重指数、总胆固醇（TC）、低密度脂蛋白（LDL-C）、甘油三酯（TG）、血尿酸（UA）、空腹血糖（FBG）、血清纤维蛋白原（FIB）水平均显著高于非CHD组,高密度脂蛋白（HDL-C）、血清总胆红素（TBIL）水平显著低于非CHD组,合并吸烟、高血压、高血脂、糖尿病的病例显著多于非CHD组（P〈0.05或P〈0.01）;（2）高脂血症、高血压、糖尿病史、TC、LDL-C、HDL-C、吸烟、FBG、年龄、FIB、TBIL入选回归方程（P〈0.05或P〈0.01）,其中高脂血症为最显著的独立相关因素（B=1.064,95%可信区间1.588～4.264,P〈0.01）。结论高脂血症、高血压、增龄、吸烟,LDL-C、TC、FBG及FIB水平升高,TBIL、HDL-C水平降低,为CHD的显著独立相关危险因素。     

MLR联合TC/HDL-C比值与ACS患者冠状动脉病变严重程度的相关性分析

目的分析单核细胞/淋巴细胞比值（MLR）联合总胆固醇/高密度脂蛋白胆固醇比值（TC/HDL-C）与急性冠脉综合征（ACS）患者冠状动脉病变严重程度的相关性。方法选择2018年1月至2020年12月因急性胸痛就诊于新疆生产建设兵团医院,诊断ACS并完成冠状动脉造影的患者。分别记录患者的性别、年龄、体重指数（BMI）、既往病史、急诊血常规指标（中性粒细胞计数（NEU）、淋巴细胞计数（LYM）、单核细胞计数（MON）、血小板计数（PLT））、脂质指标[总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）]以及冠状动脉造影等资料。计算冠状动脉Gensini积分,将Gensini积分>0分的189例患者纳入研究;根据患者Gensini积分均值,分为Gensini低分组（Gensini积分<56分,110例）和高分组（Gensini积分≥56分,79例）;比较两组之间上述指标的差异,利用线性分析各变量与Gensini积分的相关性;利用Logistic回归得到MLR与TC/HDL-C的联合诊断因子,绘制ROC曲线,评估MLR、TC/HDL...     

甲状腺功能与冠脉病变程度的相关性研究

目的探讨甲状腺激素水平与冠心病及其严重性的关系。方法冠心病患者158例,根据选择性冠状动脉造影证实冠脉病变狭窄程度,将其分为冠脉狭窄组60例和冠脉无狭窄组（对照组）98例,再将冠脉狭窄组按狭窄累及范围分为单支病变组30例、双支病变组15例和多支（3支以上）病变组15例。采用电化学发光法检测游离三碘甲腺原氨酸（fT3）、游离甲状腺素（fT4）和促甲状腺激素（TSH）水平;采用胆固醇氧化酶法测定高密度脂蛋白胆固醇（HDL．C）、总胆固醇（TC）等指标。采用Gensini评分来评价受试者冠脉狭窄程度。结果与对照组比较,冠脉狭窄的双支病变组和多支病变组患者吼水平显著降低（t=1．947、6．415,P均〈O．05）,冠脉狭窄单支病变组fT4水平显著升高（t=5．026,P〈0．05）。采用Logistic回归分析发现,fT3是冠心病的独立危险因素。以Gensini评分为因变量进行多元线性回归分析发现,几与Gensini评分呈负相关,几每降低0．234pmol／L,Gensini评分升高1分。结论fr,水平在冠状动脉狭窄患者中显著降低,并且与冠心病的严重程度密切相关,是冠心病的独立危险因素;fr。每降低0．234pmol／L,Gensini评分升高1分,可以作为冠心病风险增加的敏感指标。     

糖尿病合并冠心病患者血脂水平测定及意义

目的：探讨2型糖尿病（T2DM）合并不同类型冠心病（CHD）患者血脂谱的变化特点及意义。方法：选择2型糖尿病合并冠心病患者72例,分为2型糖尿病合并稳定型心绞痛组（对照组）27例和合并急性冠状动脉综合征组（观察组）45例。观察两组血脂谱[TC、TG、LDL-C、HDL-C、Apo-A、Apo-B1、Lp（a）]水平及其差异。结果：与对照组比较,观察组TC、TG、LDL-C、Apo-A、Apo-B1水平差异不显著（P〉0.05）,HDL-C、Lp（a）水平差异显著（P〈0.05）。结论：测定糖尿病合并冠心病患者的Lp（a）水平对鉴别诊断及危险度分层具有重要临床意义。     

脂质/高密度脂蛋白胆固醇比值对急性脑梗死患者脑动脉狭窄的诊断价值

目的：探讨急性脑梗死患者脑动脉狭窄与脂质/高密度脂蛋白胆固醇（HDL-C）比值的相关性。方法：对263例住院急性脑梗死患者行头颅MRA检查,根据MRA所提示脑动脉狭窄的检查结果分为狭窄组（n=141）和对照组（n=122）。用全自动血生化分析仪测量患者的血生化指标。结果：狭窄组和对照组血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平及TG/HDL-C比值无显著性差异（P〉0.05）;血清TC/HDL-C及LDL-C/HDL-C比值有显著性差异（P〈0.05）,HDL-C水平狭窄组低于对照组（P〈0.05）。Logistic多元回归分析年龄和HDL-C降低是脑动脉狭窄的独立危险因素。结论：在急性脑梗死患者脑动脉狭窄评估中,TC/HDL-C和LDL-C/HDL-C比值是敏感性指标。     

某医院医务人员血脂异常情况调查与分析

目的：调查了解某医院医务人员血脂异常情况。方法：选择某医院2012年度参与健康体检的医务人员1625例,采用全自动生化分析仪检测血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平。比较不同性别各年龄组血脂异常发生情况,并分析年龄与血脂水平的相关性。结果：（1）男性医务人员TC、TG、LDL-C水平,20~29岁组显著或非常显著低于其他3组（Pd0．05,P〈0．01）,30～39岁组显著或非常显著低于40~49岁组及50～59岁组（P〈0．05,P〈0．01）;20～29岁组及30~39岁组HDL-C水平均显著低于40~49岁组及50~59岁组（P〈0．05）,其余组间比较差异不显著（P〉0．05）。（2）女性医务人员各年龄组间TC、TG、LDL-C水平均差异显著或非常显著（P〈0．05,P〈0．01）;HDL-C水平各年龄组间差异不显著（P〉0．05）。（3）Spearman秩相关分析结果显示,TC、TG、LDL-C异常率与年龄增长呈显著或非常显著正相关（P〈0．05,P〈0．01）。结论：某医院医务人员血脂异常率较高,应引起医院相关部门的重视;男性和女性医务人员在49岁后均应注意检查血脂情况,早期发现、早期防治。     

化痰活血汤治疗高脂血症效果观察

目的：观察化痰活血汤治疗高脂血症的效果。方法：将高脂血症301例随机分为观察组154例和对照组147例。观察组口服化痰活血汤,每天1剂,分2次温服,连服4周;对照组口服洛伐他汀20mg/次,1次/d,睡前顿服,连服4周。比较两组服药前后总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平的变化。结果：两组治疗后TC、TG、HDL-C和LDL-C水平显著或非常显著低于治疗前（P〈0.05,P〈0.01）;两组治疗后TC、TG、HDL-C和LDL-C水平比较,差异不显著（P〉0.05）。两组体重及不良反应比较,差异均不显著（P〉0.05）。结论：化痰活血汤具有较好的降血脂作用,其降血脂效果与洛伐他汀相似。     

血脂分析联合冠状动脉CTA对糖尿病患者合并冠状动脉病变的预测价值研究

目的 探讨血脂指标检测联合冠状动脉CT血管成像对糖尿病患者合并冠状动脉病变(CAD)的临床早期预测价值。方法 搜集接受冠状动脉造影(CAG)检查的2型糖尿病(T2DM)患者共360例,平均年龄为(57.3±11.2)岁。在CAG检查后,根据SYNTAX评分对冠状动脉病变程度进行评级,分为轻度、中度与重度。所有患者接受冠状动脉CTA检查,影像科医师独立阅片评估图像。检测所有患者的血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)指标。比较合并CAD与非合并CAD的T2DM患者,以及不同冠状动脉病变程度的T2DM患者的各项血脂指标差异。以CAG检查结果为金标准,评价和对比血脂指标、冠状动脉CTA检查以及两者联合分析对T2DM合并CAD的诊断效能。结果 CAG检查结果显示,合并CAD的患者有200例(T2DM-CAD组),不合并CAD的患者有160例(T2DM组)。T2DM-CAD组患者中,轻度病变患者有70例,中度有110例,重度有20例。T2DM-CAD组患者的平均TC、TG和LDL-C均显著高于T2DM组患者(P<0.05)...     

玉树称多地区健康体检人群血脂水平检测分析

目的：了解玉树称多地区健康人群血脂四项水平状况,观察高原地区缺氧环境及饮食习惯对本地区人群血脂水平的影响,分析其性别差异和随年龄变化的规律。方法：在日立7600型全自动生化分析仪上釆用CHOD-POD法,GPO-PAP法和直接法对1 176名健康体检人员总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDLC）进行检测分析。结果：玉树称多地区健康体检人群男女血脂四项水平呈正态性分布,血脂平均水平男性：TC为4.53mmol/L,TG为1.73mmol/L,HDL-C为1.17mmol/L,LDL-C为2.79mmol/L,女性：TC为4.48mmol/L,TG为1.67mmol/L,HDL-C为1.29mmol/L,LDL-C为2.77mmol/L。不同年龄,不同性别及藏、汉族间均有不同程度差异,同年龄段男性血脂四项水平与女性比较,男性高于女性,差异均有统计学意义（P〈0.01）。男女各年龄组之间有显著性差异具有统计学意义（P〈0.05）,藏族高于汉族（P〈0.05）。结论：玉树称多地区健康体检人群血脂四项水平男女之间、男性各年龄组,女性各年龄组之间,藏族、汉族之间有显著性差异,高原缺氧环境及饮食习惯是影响血脂水平的重要因素。     

冠状动脉介入治疗对血小板活化及纤溶功能的影响

目的 研究经皮冠状动脉介入治疗(PCI)对外周循环血中血小板活化及纤溶功能的影响。方法 由外周血管采血，采用ELISA检测冠心病患者PCI前后血浆小板表面α-颗粒膜蛋白(GMP-140)、血管性假血友病因子(vWF)、组织纤溶酶原激活剂(t—PA)、纤溶酶原激活剂抑制物-1(PA1-1)、D-二聚体(D-D)的含量。结果 65例冠心病患者PCI术后10min血浆血小板膜表面GMP-140、D-D和t—PA明显增高，术后24h PAI、vWF才显著增高。结论 冠心病患者PCI术后确有血小板活化和纤溶功能的变化。     

Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease

The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 ± 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 ± 4 months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions (≥50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis.     

Aortic atherosclerosis detected with electron-beam CT as a predictor of obstructive coronary artery disease

RATIONALE AND OBJECTIVES: Several studies have demonstrated an association between coronary and aortic atherosclerosis. Aortic atherosclerosis is easily quantified by means of electron-beam computed tomography (CT). The aim of this study was to evaluate the usefulness of measurement of aortic atherosclerosis with electron-beam CT as an independent predictor of obstructive coronary artery disease (CAD). MATERIALS AND METHODS: Ninety-seven patients (67 men, 30 women; mean age, 61 years +/- 12) were enrolled and underwent electron-beam CT with and without contrast material. Coronary artery calcification was quantified with nonenhanced electron-beam CT by means of Agatston score. CAD was defined as luminal narrowing of the coronary artery by at least 70%, as measured with electron-beam angiography. Aortic atherosclerosis was quantified by measuring raised lesions of the aortic wall (plaque) and wall thickening (volume and thickness) in the midportion of the descending thoracic aorta (10 contiguous sections), as depicted at contrast material-enhanced CT angiography. RESULTS: Aortic plaque and calcification were detected only in patients who were at least 58 years old. The presence of aortic plaque was predictive of obstructive CAD, independent of coronary artery calcification. The sensitivity of aortic plaque (raised lesions) for obstructive CAD was 89% in patients at least 58 years old, and the specificity was 63%. Aortic calcification had a sensitivity of 56% and a specificity of 72% for diagnosis of obstructive CAD. CONCLUSION: This study demonstrated that aortic plaque detected with contrast-enhanced electron-beam CT was a more consistent predictor of obstructive CAD than other independent aortic variables. Aortic calcification depicted on nonenhanced CT images was highly specific for obstructive CAD.     

Breath-hold 3D steady-state free precession coronary MRA compared with conventional X-ray coronary angiography

PURPOSE: To evaluate the use of breath-hold three-dimensional (3D) steady-state free precession (SSFP) coronary magnetic resonance angiography (MRA) in patients with coronary artery disease (CAD) in comparison with conventional coronary x-ray angiography (XRA). MATERIALS AND METHODS: Twenty-eight patients with suspected CAD were examined with the use of a breath-hold 3D-SSFP-MRA sequence and conventional XRA. To assess the accuracy of MRA, two clinicians who were blinded to patient information independently reviewed the MRA and XRA data, which were presented in a randomized order. To identify discrepancies between MRA and XRA, and assess features of coronary lesions on MRA, two additional clinicians examined MRA and XRA data that were presented side by side, divided into proximal, mid, and distal segments, and compared them segment by segment. RESULTS: The sensitivity and specificity for diagnosing significant coronary stenoses (> 50% diameter narrowing) were 64% and 94%, respectively. At sites of coronary lesions identified on XRA, bright signals and enlarged vessel profiles, in addition to the characteristic narrow lumen, were frequently observed on MRA. CONCLUSION: Breath-hold SSFP coronary MRA has good specificity but inconclusive sensitivity in diagnosing significant coronary stenoses, and provides important image features for depicting coronary lesions.     

冠状动脉旁路移植术后近期桥血管闭塞的相关因素分析

目的:总结分析冠状动脉旁路移植术(coronary artery bypass graft,CABG)后桥血管闭塞的相关因素,为CABG术后移植血管桥狭窄的防治提供依据。方法:分析2008-01～2010-08的228例接受CABG患者临床资料,通过Logistic多因素回归等方法分析移植血管桥闭塞的相关因素。结果:①单因素分析桥血管闭塞的因素:术前经皮冠状动脉介入治疗(PCI)病史、冠脉造影弥漫性病变、术前血糖、术后血糖、术前高密度脂蛋白胆固醇(HDL-C)、靶血管直径、左乳内动脉(LIMA)桥血流(和LIMA闭塞相关)、术后服用抗血小板药物(波立维和/或阿司匹林)、总胆固醇(TC)、术后低密度脂蛋白胆固醇(HDL-C)、术后纤维蛋白原等;②Logistic多因素回归分析:冠脉弥漫性病变、PCI病史和术后高TC是桥血管闭塞的危险因素;保护因素是术后HDL-C和服用抗血小板药物。结论:CABG术后桥血管通畅率的相关因素:术前PCI、弥漫性冠状动脉病变、术后总胆固醇、靶血管直径、术后HDL-C和术后服用抗血小板药物等。     

Sixty-four-slice computed tomography coronary angiography compared with myocardial perfusion scintigraphy for the diagnosis of functionally significant coronary stenoses in patients with a low to intermediate likelihood of coronary artery disease

Background. Multislice computed tomography coronary angiography (CTA) was proposed as a method for investigating possible coronary artery disease (CAD) in patients who present with chest pain but with a low to intermediate likelihood of CAD. Sixty-four-channel CTA was compared prospectively with ^99mTc-tetrofosmin myocardial perfusion scintigraphy (MPS) (as the gold standard in the detection of flow-limiting stenoses) for the detection of functionally significant CAD. Methods and Results. Fifty-two consecutive symptomatic patients with a low to intermediate likelihood of coronary artery disease, and who were referred for MPS, also underwent CTA. The CTA datasets were analyzed by two experienced observers who were blinded to the MPS data, and coronary artery segments were reported as <50%, 50% to 69%, 70% to 99% stenoses, or occluded. The MPS images were similarly analyzed for inducible perfusion abnormalities, and coronary territories were identified. At the patient level, agreement between CTA and MPS for CTA lesions at ≥50% was 87% (sensitivity, 100%; specificity, 84%; positive predictive value, 50%; negative predictive value, 100%). For CTA lesions, agreement at ≥70% was 96% (sensitivity, 86%; specificity, 98%; positive predictive value, 86%; negative predictive value, 98%). Conclusions. In patients with a low to intermediate likelihood of CAD, there is good correlation between MPS and CTA for the detection of functionally significant coronary artery stenoses when CTA detects a narrowing of ≥70% severity. Computed tomography coronary angiography stenoses of 70% should be used to determine functional significance, and not 50%, as is the usual practice at present. This work was funded by an unrestricted research grant from the United Kingdom Defence Postgraduate Medical Deanery. We also thank the Royal Air Force Medical Branch for financial support.     

64层螺旋CT冠状动脉成像评价冠状动脉钙化与狭窄的临床应用研究

目的探讨64层螺旋CT冠状动脉成像评价冠状动脉钙化和狭窄的临床应用价值。方法对32例临床确诊或疑诊冠状动脉粥样硬化性心脏病患者行64层螺旋CT冠状动脉成像。利用平扫图像进行钙化积分测量,冠状动脉CTA扫描后进行多平面重建（MPR）、曲面重建（CPR）及容积再现（VRT）,其中,9例行常规冠状动脉造影作对照,总结CTA的评价方法和显示情况,分析影响冠状动脉成像质量的因素。结果64层螺旋CT平扫能测定钙化积分,而MPR、CPR及VRT能多角度显示冠状动脉主干及主要分支,MPR与CPR对显示冠状动脉病变优于VRT。本组患者中,冠状动脉管壁欠光滑见于10例,管壁钙化11例,非钙化斑块15例,管腔狭窄18例。影响图像质量的因素主要是心率、心律及呼吸运动。结论64层螺旋CT冠状动脉成像是一种安全、快速、无创的诊断冠状动脉粥样硬化性心脏病的方法,也可作为筛查公众中冠状动脉病变的重要手段。     

Perfusion impairment in patients with normal-appearing coronary arteries: identification with contrast-enhanced MR imaging

PURPOSE: To prospectively determine the feasibility of using first-pass magnetic resonance (MR) imaging to distinguish between myocardial segments in patients with coronary artery disease (CAD) of different degrees of obstruction and those in patients with normal-appearing coronary arteries. MATERIALS AND METHODS: The study was approved by the institutional ethics committee, and all patients provided informed consent. First-pass contrast material-enhanced MR imaging was performed at rest and after the infusion of dipyridamole in 37 patients (29 men, eight women; mean age, 57.2 years +/- 10.5 [standard deviation]) who had positive exercise test results or a clinical history of CAD. Myocardial segments were divided into five groups according to the degree of obstruction in the supplying artery. Signal intensity upslope, peak signal intensity, and time to peak signal intensity, as well as hyperemia-to-rest (HR) ratios for each of these three variables, were analyzed for each segment by using a generalized linear model. RESULTS: Signal intensity upslope in patients with normal coronary arteries at angiography was significantly higher than that in patients with CAD (P < .001). Signal intensity upslope for segments in patients without CAD was significantly different from that for normal-appearing segments in patients with CAD (P < .001). Signal intensity upslope (P < .05) and peak signal intensity (P < .01) enabled the differentiation of segments with more than 70% reduction in luminal diameter from those in all other groups. HR ratios demonstrated findings that were similar to those obtained by using each signal intensity variable alone. CONCLUSION: First-pass MR imaging can be used to distinguish segments with different degrees of obstructive CAD. Importantly, MR imaging can help identify segments with impaired perfusion and normal-appearing coronary arteries in patients with CAD and can demonstrate obstructive lesions in other territories.     

64层螺旋CT在冠状动脉疾病诊断中的价值

目的 评价64层螺旋CT冠状动脉成像（64SCTCA）在诊断冠状动脉疾病的临床价值。方法 搜集100例患者64SCTCA的完整资料，并以近期实施的选择性X线冠状动脉成像（CCA）结果为金标准进行对比，对64SCTCA显示的冠状动脉主支及主要分支情况进行分级评估。结果 所有病例可用于评估的920支冠状动脉中，共显示病变370支，其中348支得到CCA证实；22支64SCTCA诊断狭窄而CCA显示正常，另外有10例CCA确诊存在的病变而在64SCTCA上未能显示，得出64SCTCA诊断冠状动脉病变的敏感性为97．2％，特异性为96．0％，阳性预测值为94．0％，阴性预测值为98．1％。经配对χ^2检验，P=0．052，证明两种检查方法在发现冠状动脉病变方面差异无统计学意义。在显示病变程度上，64SCTCA评估与CCA完全一致者311支，准确性86．8％。在64SCTCA结果中，共有59支病变在程度上的评价与CCA结果不符合。结论 64SCTCA在显示冠状动脉病变时，具有较高的敏感性和特异性，并且对于病变程度的评估也比较准确，适合用于临床怀疑冠心病的患者CCA前的筛选检查。     

Clinical evaluation of 99Tcm-MIBI SPECT in the assessment of coronary artery disease.

To evaluate the clinical efficacy of 99Tcm-MIBI myocardial tomography for detecting coronary artery disease (CAD) 115 consecutive patients who underwent both 99Tcm-MIBI single photon emission computed tomography (SPECT) and coronary arteriography were studied. Thirty-three patients without and 82 with significant coronary artery disease were documented by coronary arteriography. The overall sensitivity and specificity of 99Tcm-MIBI SPECT for detecting coronary artery disease were 96 and 87.9%, respectively. The sensitivity for identifying patients with CAD without myocardial infarction was 88%. The sensitivity of 99Tcm-MIBI SPECT for detecting individual coronary artery lesions was 86% for left anterior descending artery (LAD), 69% for left circumflex artery (Lcx) and 86% for right coronary artery (RCA), lesions respectively. In conclusion, 99Tcm-MIBI SPECT provides a reliable method for detecting CAD.