铊^201单光子发射计算机断层心肌显像对隐匿性冠心病预后判断的价值

目的探讨心肌潘生丁负荷／再分布铊（T1）^201单光子发射计算机断层显像（single photon emission computed tomography，SPECT）法评价隐匿性冠心病预后的可行性。方法入选1998至2005年期间94例无任何症状但运动平板试验反复阳性的飞行人员，根据SPECT心肌显像结果分为检查结果阳性组及阴性组，阳性组中根据心肌缺血累及范围又分为单个节段受累亚组、2个节段受累亚组和2个以上节段受累亚组，平均随访4．5年，比较组间的主要心血管事件（major adverse cardiovascular events，MACE）发生率。结果随访过程中，阳性组与阴性组的MACE分别为30％与7％，差异具有统计学意义（P〈0．01）。2个以上节段受累亚组组MACE发生率（100％）明显高于单个节段受累亚组（24％）、2个节段受累亚组（22％）及阴性组（7％），P均〈0．05。结论潘生丁负荷心肌T1^201-SPECT显像有助于隐匿性冠心病预后判断，从而指导临床早期干预治疗。

Prognostic value of thallium-201 myocardial perfusion single photon emission computed tomography in aircrew with silent coronary artery disease

Objective To investigate the incremental prognostic value of dipyridamole thallium-201 myocardial perfusion SPECT imaging in asymptomatic aircrew whose treadmill stress test results were positive. Methods Ninety-four asymptomatic aircrew cases whose treadmill stress test results were positive underwent dipyridamole thallium-201 myocardial perfusion imaging in 1998--2005 and they were divided into positive or negative group according to the results. Over a mean follow-up period of 4.5 years, the rate of MACE （major adverse cardiovascular events） between the two groups were compared. Results MACE developed in 30% of the positive group subjects and 7% of the negative group subjects （P 〈 0. 01 ）. The cases who had over two ischemic segments in imaging developed more cardiac events compared with other cases （P 〈 0.05 ）. Conclusion Thallium-201 myocardial perfusion imaging is helpful in predicting the prognosis of aircrew with silent coronary artery disease.