99Tcm-MIBI心肌灌注显像对行PCI术的冠心病患者中的近期效果的评估作用

目的 探讨99Tcm-MIBI心肌灌注显像（99Tcm-MIBI）对行经皮冠状动脉介入治疗（PCI）术的冠心病患者近期疗效的评估作用。 方法 收集2014年10月至2017年3月于重庆市涪陵中心医院行PCI术的冠心病患者124例，其中，男性68例、女性56例，年龄43~79（61.89±17.21）岁。术前3 d内给予负荷心肌灌注显像（99Tcm-MIBI-SMPI）和静息心肌灌注显像（99Tcm-MIBI-RMPI）检查，术后3 d内给予99Tcm-MIBI-SMPI检查。所有患者均进行为期1年的电话随访，按缺血完全改善、部分改善、未改善分为3组，统计发生一般心血管事件和严重心血管事件的例数。两组间计量资料的比较采用student-t检验，计数资料的比较采用χ 2检验。 结果 124例患者中，PCI术前99Tcm-MIBI-SMPI检查显示可逆性缺损节段272个，不可逆性缺损节段360个，总负荷分值（SSS）1598分；PCI术后99Tcm-MIBI-SMPI检查显示可逆性缺损节段25个，改善247个（247/272=90.81%），不可逆性缺损节段198个，改善162个（162/360=45.00%），SSS总分636分。患者PCI术后的心功能参数左心室射血分数、舒张末容积和收缩末期容积较PCI术前均有明显的改善，且差异均有统计学意义（t=?7.450、4.304、12.144，均P<0.01）；术后99Tcm-MIBI-SMPI 显示缺血完全改善、部分改善、未改善3组患者半年和一年心血管事件总发生率有明显的升高趋势（χ2=142.668、106.225，均P<0.05）。 结论 99Tcm-MIBI心肌灌注显像检查用于评估冠心病患者行PCI术的近期疗效有较好作用，且对患者的远期预后有一定的预测效果。

The recent effect observation of 99Tcm-MIBI myocardial perfusion imaging in coronary heart disease patients with percutaneous coronary intervention

Objective To explore the recent effect of 99Tcm-methoxyisobutylisonitrile myocardial perfusion imaging (99Tcm -MIBI) in coronary heart disease (CHD) patients with percutaneous coronary intervention (PCI). Methods From October 2014 to March 2017, a total of 124 patients [including 68 males and 56 females, aged 43~79 (61.89±17.21)] with CHD undergoing PCI in Fuling central hospital were used as research objects and underwent adenosine-loading myocardial perfusion imaging (99Tcm -MIBI-SMPI) and 99Tcm MIBI rest myocardial perfusion imaging (99Tcm-MIBI-RMPI) within 3 days before PCI and 99Tcm-MIBI-SMPI within 3 days after PCI. All patients were followed up for 1 year via telephone calls. According to complete improvement, partial improvement and no improvement of ischemia, they were divided into three groups. The cases of general cardiovascular events and serious cardiovascular events were calculated. Student-t test was used to compare the measurement data between the two groups, and χ2 test was used to compare the count data. Results In the 124 patients, 99Tcm-MIBI-SMPI examination before PCI showed 272 reversible defect sections and 360 irreversible defect sections. The summed stress score was 1598 points. 99Tcm-MIBI-SMPI examination after PCI showed 25 reversible defect sections, 247 sections (247/272=90.81%) improved, 198 irreversible defect sections, and 162 sections (162/360=45.00%) improved. The summed stress score was 636 points. After PCI, the left ventricular ejection fraction, end diastolic velocity, and end systolic volume of patients showed significant improvement. The differences were statistically significant (t=?7.450, 4.304, 12.144, all P<0.01). Postoperative 99Tcm MIBI-SMPI indicated the completely improved, improved, and partly improved status of the three groups of ischemia patients, and the improvement showed an significantly increased trend in both half year and 1 year total incidence of cardiovascular events (χ2=142.668, 106.225, both P<0.05). Conclusion 99Tcm-MIBI has good effect on CHD patients with PCI and on their long-term prognosis.