99Tcm-MIBI门控心肌灌注显像在2型糖尿病无症状心肌缺血患者中的价值

目的 探讨门控心肌灌注显像应用于2型糖尿病无症状心肌缺血患者中的价值。 方法 以83例经确诊的2型糖尿病并接受了门控负荷心肌灌注显像的患者作为2型糖尿病组, 51名无糖尿病史及明确的心血管病史的受检者作为对照组。17节段法分析两组受检者的负荷及静息心肌灌注显像, 由两位有经验的医师进行视觉分析结合5点评分法评估左心室缺血节段, 对比软件自动评分法计算两组的负荷总积分、静息总积分和积分差值, 并作统计分析。 结果 两组受检者左心室均未出现固定性心肌灌注缺损节段; 血流灌注异常节段的差异具有统计学意义(χ2=24.19, P < 0.05)。2型糖尿病组与对照组的负荷总积分和静息总积分之间的差异都具有统计学意义(t=7.13、3.15, P均 < 0.05);两组的积分差值比较差异无统计学意义(t=1.44, P > 0.05)。对照组的负荷总积分与静息总积分比较差异无统计学意义(t=1.795, P > 0.05);运动负荷后两组受检者左室射血分数的差异有统计学意义(t=-7.65, P < 0.05)。 结论 门控负荷心肌灌注显像在2型糖尿病人群中的恰当利用对评估无症状心肌缺血是有价值的。

Significance of 99Tcm-MIBI gated myocardial perfusion imaging in patients with type 2 diabetes but without myocardial ischemia symptoms

Objective To explore the significance of 99Tcm-MIBI gated myocardial perfusion imaging in patients with type 2 diabetes but without myocardial ischemia symptoms.Methods Eightythree patients with confirmed type 2 diabetes represented the test group and underwent 99Tcm-MIBI gated myocardial perfusion imaging;51 patients with neither type 2 diabetes nor history of cardiovascular diseases represented the control group and underwent the same examination.Each image of the leftventricle myocardium was divided into 17 segments for semi-quantitative analysis.All the segments were evaluated in consensus by two experienced doctors.Results were scored using a five-point scoring system and then referred to the system software's auto-scores.The summed stress score (SSS),summed rest score (SRS),summed difference score (SDS),left ventricular ejection fraction (LVEF),peak perfusion rate,and peak ejection rate were determined during both stress imaging and rest imaging.Results Nonreversible defects were not observed in the segments obtained from the two groups.However,the difference between the abnormal perfusion segments of the two groups was significant (x2=24.19,P＜0.05);the difference between the SSS and SRS (t=7.13,3.15,P＜0.05) of the two groups was also significant,but no difference was noted in the SDS(t=1.44,P＞0.05) of both groups.Moreover,no significant difference existed between the SSS and SRS in the control group (t=1.795,P＞0.05).By contrast,the difference in the post-stress LVEF between the two groups was significant(t=-7.65,P＜0.05).Conclusions Even without cardiac symptoms,patients with type 2 diabetes should undergo 99Tcm-MIBI gated myocardial perfusion imaging for further analysis.