应用腺苷负荷心肌灌注显像随访老年冠状动脉介入术后患者的临床研究

目的 观察腺苷负荷心肌灌注显像对老年经皮冠状动脉介入治疗(PCI)患者疗效评估包括心肌血运恢复及心功能恢复情况。 方法 选择怀疑冠心病和已明确诊断老年冠心病患者，常规完成冠状动脉造影，53例行PCI，于PCI前、后6个月进行腺苷负荷心肌灌注显像检查，并同时进行心血管主要不良事件随访，完成随访40例。腺苷负荷心肌灌注显像把心肌分为16节段，计算核素扫描总积分及测定心功能。 结果 心肌扫描总积分与冠状动脉总狭窄指数呈正相关(r=0.675，P＜0.01);PCI后心肌扫描总积分与治疗前比较明显减低，分别为（2.2±2.3）与（4.5±1.9）分，差异有统计学意义(t=7.348，P＜0.01)；PCI术后心肌灌注改善总有效率86.8％(40/53);PCI术后左心室射血分数较术前明显改善，分别为(58.3±10.5)％与（53.8±10.3）％，差异有统计学意义(t=3.497，P＜0.01)。 结论腺苷负荷心肌灌注显像作为一种无创的检测方法可以准确判定老年PCI术后血流恢复及心功能恢复情况，对老年人PCI术后疗效评价具有一定优势。

Adenosine-stress myocardial perfusion imaging for post-operation follow-up after percuteneous coronary intervention in the elderly patients

Objective To evaluate the value of adenosine-stress myocardial perfusion imaging (MPI)in post-operation follow-up after the percutaneous coronary intervention(PCI) in the elderly.Methods There were patients (53 cases) underwent adenosine-stress MPI prior to and 6 months after PCI. Major adverse cardiovascular events (MACE) were followed. Left ventricular ejection fraction (LVEF) was analyzed in 40 cases. The image of the left ventricular myocardium was divided into 16 segments to calculate total defect score using a 4-grade assessment. Myocardial scintigrams were evaluated by calculating the summed adenosine-stress score and coronary angiography assessed by calculating the summed score of coronary artery stenosis.Results There was a significant correlation between the scores of coronary artery stenosis and adenosine-stress MPI scores (r=0.675,P＜0.01). Adenosine-stress MPI scores were obviously lower after PCI than before(2.2± 2.3 vs. 4.5±1.9,t= 7.348, P＜0.01); LVEF was significantly greater after PCI than pre-operation[(58.3±10.5 ) ％ vs. (53.8 ± 10.3) ％, t = 3.497, P＜0.01] and the effective rate for myocardial perfusion were 86.84 ％. Conclusions Adenosine stress MPI is a good noninvasive diagnostic method with high accuracy and plays an important role for evaluating recovery of myocardial perfusion and left ventricle function in the elderly patients after PCI.