CAJ | 학술논문

目的应用MPI评价代谢综合征(MS)患者心肌血流灌注情况.方法选择确诊或疑似冠心病患者342例行常规门控运动+静息MPI;根据代谢指标异常情况分为4组,组1:无代谢指标异常;组2:具有1个代谢指标异常;组3:具有2个代谢指标异常;组4:具有3个或3个以上代谢指标异常.分析代谢指标异常数量与MPI的关系.对符合中华医学会糖尿病分会MS 诊断标准、在显像前后1个月内行CAG检查的103 例患者的MPI结果,以CAG结果为标准,分析2种方法间诊断的一致性.采用SPSS 13.0 软件,组间心肌灌注异常的发生率比较采用χ2检验,方法间的一致性分析用Kappa 检验.结果 (1)与CAG比较,MPI诊断冠心病的灵敏度为80.5%(33/41),特异性85.5%(53/62),阳性预测值78.6%(33/42),阴性预测值86.9%(53/61),诊断准确性为83.5%(86/103),Kappa 值为0.657,P<0.001.(2)随代谢指标异常数量增加,心肌灌注异常的发生率增加:组1为23.3%(10/43),组2为32.9%(26/79),组3为54.4%(56/103),组4为57.3%(67/117),χ2=23.22,P<0.001.结论 MPI可以应用于MS患者的心肌血流评估;代谢指标异常数量增加,心肌灌注异常的发生率增加.
목적 응용MPI평개대사종합정(MS)환자심기혈류관주정황.방법 선택학진혹의사관심병환자342례행상규문공운동+정식MPI;근거대사지표이상정황분위4조,조1:무대사지표이상;조2:구유1개대사지표이상;조3:구유2개대사지표이상;조4:구유3개혹3개이상대사지표이상.분석대사지표이상수량여MPI적관계.대부합중화의학회당뇨병분회MS 진단표준、재현상전후1개월내행CAG검사적103 례환자적MPI결과,이CAG결과위표준,분석2충방법간진단적일치성.채용SPSS 13.0 연건,조간심기관주이상적발생솔비교채용χ2검험,방법간적일치성분석용Kappa 검험.결과 (1)여CAG비교,MPI진단관심병적령민도위80.5%(33/41),특이성85.5%(53/62),양성예측치78.6%(33/42),음성예측치86.9%(53/61),진단준학성위83.5%(86/103),Kappa 치위0.657,P<0.001.(2)수대사지표이상수량증가,심기관주이상적발생솔증가:조1위23.3%(10/43),조2위32.9%(26/79),조3위54.4%(56/103),조4위57.3%(67/117),χ2=23.22,P<0.001.결론 MPI가이응용우MS환자적심기혈류평고;대사지표이상수량증가,심기관주이상적발생솔증가.
Objective To evaluate the myocardial blood supply in patients with metabolic syndrome (MS) using 99Tcm-MIBI SPECT MPI. Methods A total of 342 patients were divided into four groups according to the number of abnormal metabolic indices: no abnormal metabolic index (Group 1), one abnormal index (Group 2), two abnormal indices (Group 3), three or more abnormal indices (Group 4). Each patient underwent two-day protocol of gated stress and rest 99Tcm-MIBI MPI. One hundred and three of the 342 patients were clinically diagnosed as MS and underwent CAG within 1 month after MPI. χ2test was used to evaluate the difference among the four groups and Kappa test to analyze the correlation between MPI and CAG. Results Compared with CAG, the diagnostic sensitivity, specificity, positive and negative predictive values by 99Tcm-MIBI SPECT MPI for coronary artery diseases (CAD) in 103 MS patients were 80.5% (33/41), 85.5% (53/62), 78.6% (33/42) and 86.9% (53/61), respectively. The correlation coefficient between MPI and CAG was 0.657 (P<0.001). The abnormal MPI rates in group 1, 2, 3 and 4 were 23.3% (10/43), 32.9% (26/79), 54.4% (56/103), and 57.3% (67/117), respectively (χ2=23.22, P<0.001). Conclusions In MS patients,99Tcm-MIBI SPECT MPI can be useful for evaluating myocardial blood supply and the myocardial ischemia rates may correlate positively with the number of abnormal metabolic indices.