国产腺苷的安全性评价及其负荷心肌灌注显像诊断冠心病的价值

目的：评价国产腺苷临床应用安全性及腺苷负荷心肌灌注显像对冠心病的诊断价值。方法：对51例临床疑诊冠心病患者,分别静脉注射腺苷,注射3 min末,静脉注射核素显像剂99Tcm-MIBI 925 MBq,1～1.5 h行心肌灌注断层显像,分析患者在腺苷注入后的血流动力学改变、副作用发生情况。经半年以上随访排除或确诊冠心病,评价腺苷负荷心肌灌注显像对冠心病的诊断价值。结果：腺苷输注后,86.3%（44/51）患者出现各种副作用,停药后均很快缓解。腺苷负荷试验心肌灌注显像诊断冠心病的敏感性90.9%,特异性71.4%,准确性88.2%,阳性预测值95.2%,阴性预测值55.6%。结论：国产腺苷可安全地应用于负荷心肌灌注显像。腺苷负荷心肌灌注显像诊断冠心病敏感性较高,具有重要的临床应用价值。

Safety Evaluation and Diagnostic Value of Domestic-made Adenosine in Pharmacological Stress with Myocardial Perfusion Imaging for Coronary Artery Disease

Objective： To evaluate the safety and diagnostic value of domestic-made adenosine stress test with myocardial perfusion imaging for coronary artery disease.Methods： A total of 51 patients were included in this study.Adenosine was infused.At the end of 3 minute of adenosine infusion.925MBq of 99mTc-MIBI was injected intravenously.SPECT myocardial imaging acquisition was obtained 1-1.5 hour after adenosine infusion.Hemodynamic chang and side effects caused by adenosine infusion were analyzed.By more than half a year follow-up to exclude or diagnosed coronary artery disease,and thus evaluation of adenosine stress myocardial perfusion imaging for diagnosing coronary artery disease.Results： The rate of side effects caused by domestic-made adenosine infusion was 86.3%（44 of 51 patients）,but most of the side effects were mild and transient.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of adenosine myocardial perfusion imaging for detection of coronary artery disease was 90.9%,71.4%,88.2%,95.2%,55.6% respectively.Conclusion： Domestic-made adenosine can be safely applied in the stress test during myocardial perfusion imaging,and it is an sensitive method for detecting coronary artery disease.