去甲乌药碱负荷心肌灌注显像评价冠心病心肌血供

目的 评价盐酸去甲乌药碱（HG）负荷核素心肌灌注显像（MPI）对冠心病（CHD）的诊断价值。方法 对65例入选患者采用交叉试验法分别先后给予HG注射液（HG组）和安慰剂注射液（安慰剂组）的负荷试验，行负荷-静息^99mTc-MIBI MPI检查，以CAG结果为金标准，计算HG负荷显像诊断CHD的灵敏度、特异度、准确率、阳性预测值和阴性预测值。结果 HG注射液心脏负荷试验MPI诊断CHD的灵敏度为69.57%（16/23）、特异度为97.62%（41/42）、准确率为87.69%（57/65）、阳性预测值为94.12%（16/17）、阴性预测值为85.42%（41/48）。在HG负荷试验中，63例患者出现不同程度的不良反应，表现为心悸（57例）、胸闷（17例）、头晕（1例）、胸痛（10例）等，症状较轻微，停药后10 min内自行缓解。结论 HG作为心脏负荷试验药物用于MPI诊断CHD，具有较好的诊断效能，其不良反应轻微，安全可行，有望成为一种新型的心脏负荷试验药物。

Evaluation of myocardial blood supply in coronary heart disease with hydrochloric higenamine stress radionuclide myocardial perfusion imaging

Objective To observe the value of hydrochloric higenamine (HG) as the medicine of cardiac stress test by using radionuclide myocardial perfusion imaging (MPI) in diagnosis of coronary heart disease(CHD). Methods Totally 68 consecutive patients with suspected or diagnosed CHD underwent stress-rest MPI. All patients underwent hydrochloric HG and the placebo stress MPI test by intravenous access, respectively, as well as CAG, and the results of the latter were taken as golden standards. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of hydrochloric HG as the medicine of cardiac stress MPI test to diagnose CHD were calculated. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of HG-MPI test was 69.57% (16/23), 97.62% (41/42), 87.69% (57/65), 94.12% (16/17) and 85.42% (41/48), respectively. Adverse reactions of different degrees occurred in 63 patients, mainly including palpitations (n=57), chest (n=17), dizziness (n=1) and chest pain (n=10), most of which gradually relieved within 10 min. Conclusion Hydrochloric HG as the medicine of cardiac stress test by using MPI has good diagnostic efficacy for CHD and mild adverse reactions, which may become a new type of cardiac stress test drug.