| ATP负荷 99mTc-MIBI门控心肌SPECT显像在冠状动脉临界病变危险分层中的价值 |
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| 引用本文： | 李勇,张海山,胡文强,骆雅丽,辛越,王丽娟,孙英贤.ATP负荷 99mTc-MIBI门控心肌SPECT显像在冠状动脉临界病变危险分层中的价值[J].中国动脉硬化杂志,2018,26(6):626-632. |
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| 作者姓名： | 李勇 张海山 胡文强 骆雅丽 辛越 王丽娟 孙英贤 |
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| 作者单位： | 中国医科大学附属第一医院心内科 |
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| 摘 要： | 目的探讨三磷酸腺苷(ATP)负荷99m锝-甲氧基异丁基异腈(~(99m)Tc-MIBI)门控心肌单光子发射计算机断层显像(SPECT)在评价冠状动脉临界病变危险分层中的价值。方法选择100例以冠状动脉造影明确诊断为冠状动脉临界病变的患者,行ATP负荷~(99m)Tc-MIBI门控心肌SPECT显像检查,将左心室心肌短轴和垂直长轴像划分为17个节段,采用视觉半定量评价法评价各心肌节段核素分布情况,计算左心室负荷总积分(SSS)、左心室静息总积分(SRS)、左心室总积分差(SDS),统计缺血节段数,根据SSS值和缺血节段数对患者进行危险分层;分析冠状动脉临界病变患者的危险分层及心肌缺血程度;探究冠状动脉临界病变狭窄程度与心肌缺血及危险分层的相关性。结果 100例冠状动脉临界病变患者,其中单支病变患者62例,双支病变患者33例,三支病变患者5例。对临界病变患者进行危险分层:低危组45例(45.0%),中危组34例(34.0%),高危组21例(21.0%)。多支病变组高危患者比例高于单支病变组,多支病变组SSS和SDS值也高于单支病变组(P0.05),而SRS值无明显差异。所有患者共累及143支冠状动脉临界病变,其中左前降支84支,左回旋支29支,右冠状动脉30支,三组之间SSS值、SDS值、SRS值无明显差异(P0.05)。冠状动脉临界病变患者中,轻度狭窄患者与中度狭窄患者间低、中、高危患者的分布无明显差异。冠状动脉狭窄程度与SSS、SRS及SDS间无相关关系。ATP负荷~(99m)Tc-MIBI门控心肌SPECT显像对冠状动脉临界病变患者心肌缺血检出率显著高于动态心电图检出率(76.0%比39.0%,P0.05)。结论ATP负荷~(99m)Tc-MIBI门控心肌SPECT显像可以较准确地对冠状动脉临界病变患者进行危险分层,指导临床治疗。
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| 关 键 词： | 三磷酸腺苷 99m锝-甲氧基异丁基异腈 心肌SPECT显像 冠状动脉临界病变 危险分层 |
| 收稿时间： | 2017/8/2 0:00:00 |
| 修稿时间： | 2017/12/13 0:00:00 |
The value of ATP stress 99mTc-MIBI gated myocardial SPECT imaging in the risk stratification of intermediate coronary lesion |
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| LI Yong,ZHANG Hai-Shan,HU Wen-Qiang,LUO Ya-Li,XIN Yue,WANG Li-Juan and SUN Ying-Xian.The value of ATP stress 99mTc-MIBI gated myocardial SPECT imaging in the risk stratification of intermediate coronary lesion[J].Chinese Journal of Arteriosclerosis,2018,26(6):626-632. |
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| Authors: | LI Yong ZHANG Hai-Shan HU Wen-Qiang LUO Ya-Li XIN Yue WANG Li-Juan and SUN Ying-Xian |
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| Institution: | Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China,Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China,Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China,Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China,Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China,Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China and Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China |
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| Abstract: | |
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| Keywords: | Adenosine triphosphate 99mTc-Methoxyisobutylisonitri Myocardial single-photon tomography imaging Intermediate coronary lesions Risk stratificatioin |
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