静息99mTc-MIBI心肌灌注断层显像诊断男性冠心病价值评估

目的：研究静息^99mTc-MIBI心肌灌注单光子发射计算机断层显像（SPECT）对男性冠心病的诊断价值。方法：以选择性冠状动脉造影术（CAG）为对照，将57例男性患者分为冠心病组（33例）及非冠心病组（24例），计算SPECT的各项评价指标，继而结合临床诊断将冠心病组分为心肌梗塞组（18例）及心绞痛组（15例），比较两组SPECT阳性率差异。结果：静息SPECT诊断男性冠心病灵敏度为87．88％，特异度为70．83％，准确度为80．70％，阴性预测值为80．95％，提示SPECT对男性冠心病检出率，符合率较高，而阴性对排除冠心病有较高的价值，心肌梗塞组阳性率为100％（18／18），心绞痛组为73．33％（11／15），提示静息SPECT检出男性心肌梗塞的阳性率高于心绞痛。结论：结合实验结果及SPECT具有无创，价廉，可重复等特点，SPECT可作为诊断男性冠心病的初筛检查。

Evaluation of rest 99mTc-MIBI myocardial perfusion SPECT in diagnosing male CAD

Objective:To explore the value of rest 99mTc MIBI myocardial perfusion SPECT in diagnosing male coronary artery disease(CAD).Methods:Based on coronary angiography(CAG) and clinical diagnosis,57 patients were classified as CAD group(33 cases) and non CAD group(24 cases)which include 15 cases without organic heart problems and 9 cases of other heart diseases.Several diagnosing indexes of SPECT were calculated and positive rates of SPECT in diagnosing MI and angina were compared.Results:Sensitivity and specificity of SPECT were 87 88%and 70 83%,respectively.Accuracy was 80 70%and negative predictive value was 80 95%,so it suggests that SPECT has a higher positive rate and coincidence rate in male CAD.When in negative result,it has important value in excluding CAD In myocardium infarction and pectoralis angina group.The positive rate were 100%(18/18)and 73 33%(11/15) respectively.Conclusion:According to examination and SPECT result,SPECT can be used as a screening method for male CAD due to its noninvasiveness,low cost and the ability to be used repeatedly.