文章摘要
袁冬兰,袁冬青,冯建林,周艳丽,赵中强,陈建玉,李殿富.腺苷负荷核素心肌灌注显像对冠心病的诊断价值及其安全性观察[J].南京医科大学学报,2012,(8):1140~1143
腺苷负荷核素心肌灌注显像对冠心病的诊断价值及其安全性观察
The application and safty of adenosine stress myocardial perfusion tomographic imaging in detecting coronary artery disease
投稿时间:2011-06-08  
DOI:10.7655
中文关键词: 冠心病  核素心肌灌注显像  腺苷  心脏负荷试验  不良反应
英文关键词: coronary disease  myocardial perfusion imaging  adenosine  burden test  adverse reaction
基金项目:江苏省兴卫工程重点人才项目(K201103);江苏省人民医院心血管病临床医学中心开放课题(ZX07200907)
作者单位
袁冬兰 南京医科大学第一附属医院核医学科江苏 南京 210029 
袁冬青 南京医科大学第一附属医院眼科,江苏 南京 210029 
冯建林 南京医科大学第一附属医院核医学科江苏 南京 210029 
周艳丽 南京医科大学第一附属医院核医学科江苏 南京 210029 
赵中强 南京医科大学第一附属医院核医学科江苏 南京 210029 
陈建玉 南京医科大学第一附属医院核医学科江苏 南京 210029 
李殿富 南京医科大学第一附属医院核医学科江苏 南京 210029 
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中文摘要:
      目的:观察腺苷负荷核素心肌灌注显像(myocardial perfusion imaging,MPI)对于冠心病诊断的敏感性?特异性及其安全性?方法:对85例临床确诊或疑似冠心病患者行99m 锝-甲氧基异丁基异腈(99mTc-MIBI)腺苷负荷和静息心肌灌注显像?腺苷注射过程中进行心电监测,观察并记录患者的症状?血压和心率;于注射腺苷1 h后进行MPI,次日常规行静息心肌灌注显像?其中67例患者在进行MPI后1个月内接受冠状动脉造影(coronary angiography,CAG)检查?以CAG结果为金标准,3条主要血管至少有1支血管管径狭窄≥50%为阳性标准进行分析?结果:① 67例CAG检查患者中,获得阳性结果者52例,其中核素心肌灌注显像阳性46例;而CAG检查无明显狭窄的15例中,11例核素心肌灌注显像阴性?腺苷负荷MPI对于冠心病诊断的敏感性和特异性分别为88.5%和73.3%?② 85例心肌灌注显像患者中,91.7% (78/85)出现各种不良反应,其中胸部不适83.3%(65/78),其次为潮热23.1%(18/78)?头昏20.5%(16/78)?心悸12.8%(10/78)?气短7.7%(6/78)?出汗7.7%(6/78),偶有恶心3.8%(3/78)?低血压3.8%(3/78)?呕吐1.3%(1/78)等?在停止注射腺苷5 min后,患者不良反应消失,心率?血压恢复至基础水平?结论:腺苷负荷MPI对于冠心病诊断的敏感性?特异性较高,不良反应较轻微,且终止试验后不良反应迅速消失,安全性较高?
英文摘要:
      Objective:To analyze the sensitivity and specificity of adenosine stress myocardial perfusion imaging for the diagnosis of coronary artery disease(CAD) and to observe the adverse reaction of adenosine burden test. Methods:A total of 85 inpatients were included in this study. SPECT myocardial imaging acquisition was obtained 1 hour after adenosine infusion. Rest myocardial perfusion imaging would be performed next day regularly. Coronary angiography was performed in 67 patients within one month of myocardial imaging. Results:① Total 85 cases[(66 ± 9) years old,46 men,39 women]were included in this study. In the 52 cases of CAD patients confirmed by coronary angiography,46 patients have positive adenosine 99mTc-MIBI myocardial perfusion SPECT. Of 15 cases without CAD,11 cases have negative adenosine myocardial perfusion tomographic imaging. The sensitivity and specificity of adenosine myocardial perfusion tomographic imaging for the diagnosis of CAD were 88.5% and 73.3%. ② In the 85 patients,8.3% patients had no symptom,91.7% had varied kinds of adverse reaction,consisted of chest complaint(83.3%),skin aestus(23.1%),dizziness(20.5%),palpitation(12.8%),short breath(7.7%),sweating(7.7%) and so on. At the end of 5 minutes of stopping adenosine infusion,all adverse reaction disappeared,heart rate and blood pressure returned to basal level. Conclusion:Adenosine stress myocardial perfusion tomographic imaging is an useful and safty non-interventional method for detecting coronary artery disease.
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