中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2010年
4期
251-254
,共4页
川玲%赵文锐%方庭正%何疆春%梁英魁%王新强%王升%高春华%王春芳%许根祥%王伟%杨晔
川玲%趙文銳%方庭正%何疆春%樑英魁%王新彊%王升%高春華%王春芳%許根祥%王偉%楊曄
천령%조문예%방정정%하강춘%량영괴%왕신강%왕승%고춘화%왕춘방%허근상%왕위%양엽
冠状动脉疾病%冠状动脉造影术%体层摄影术,发射型计算机,单光子%腺苷%MIBI
冠狀動脈疾病%冠狀動脈造影術%體層攝影術,髮射型計算機,單光子%腺苷%MIBI
관상동맥질병%관상동맥조영술%체층섭영술,발사형계산궤,단광자%선감%MIBI
Coronary disease%Coronary angiography%Tomography,emission-computed,single-photon%Adenosine%MIBI
目的 探讨腺苷负荷99Tcm-甲氧基异丁基异腈(MIBI)心肌显像与冠状动脉(简称冠脉)造影慢血流现象的关系.方法 44例患者均经冠脉造影及腺苷负荷99Tcm-MIBI心肌血流灌注显像,分析比较冠脉造影阳性组(P-CAG)12例,冠脉慢血流组(CSF)22例以及冠脉正常血流组(NCF)10例患者临床资料、腺苷心肌负荷显像改变、冠脉造影结果与腺苷负荷心肌显像的关系.结果 采用方差分析、t检验或x2检验比较.结果 3组临床资料(包括年龄、性别和危险因素:高血压史、高脂血症及糖尿病发病率)差异均无统计学意义(年龄:t=0.27,0.54和0.59;性别:x2=0.92;危险因素:x2=1.23;P均＞0.05);CSF组冠脉心肌梗死溶栓疗法(TIMI)血流帧数明显多于NCF组(33.7±5.5和17.6±3.9,t=-9.58,P＜0.001).P-CAG组12例,腺苷负荷心肌显像阳性率100%(12/12);CSF组22例,阳性率77.3%(17/22);NCF组10例,2例阳性.半定量靶心图分析示腺苷负荷试验心肌缺血范围(人均缺血节段数)CSF组多于NCF组(1.06±0.77和0.91±0.80,t=-2.02,P＜0.05),少于P-CAG组(2.41±0.79,t=4.54,P＜0.001).靶心图记分心肌缺血程度显示CSF组大于NCF组(8.01±6.06和2.73±2.60,t=-2.07,P＜0.05),小于P-CAG组,但差异无统计学意义(14.07±12.77,t=1.44,P＞0.05).结论 腺苷负荷心肌灌注阳性显像中部分患者伴有冠脉造影慢血流现象,这为有明显胸痛症状但冠脉造影阴性的患者提供了诊断和治疗依据.
目的 探討腺苷負荷99Tcm-甲氧基異丁基異腈(MIBI)心肌顯像與冠狀動脈(簡稱冠脈)造影慢血流現象的關繫.方法 44例患者均經冠脈造影及腺苷負荷99Tcm-MIBI心肌血流灌註顯像,分析比較冠脈造影暘性組(P-CAG)12例,冠脈慢血流組(CSF)22例以及冠脈正常血流組(NCF)10例患者臨床資料、腺苷心肌負荷顯像改變、冠脈造影結果與腺苷負荷心肌顯像的關繫.結果 採用方差分析、t檢驗或x2檢驗比較.結果 3組臨床資料(包括年齡、性彆和危險因素:高血壓史、高脂血癥及糖尿病髮病率)差異均無統計學意義(年齡:t=0.27,0.54和0.59;性彆:x2=0.92;危險因素:x2=1.23;P均＞0.05);CSF組冠脈心肌梗死溶栓療法(TIMI)血流幀數明顯多于NCF組(33.7±5.5和17.6±3.9,t=-9.58,P＜0.001).P-CAG組12例,腺苷負荷心肌顯像暘性率100%(12/12);CSF組22例,暘性率77.3%(17/22);NCF組10例,2例暘性.半定量靶心圖分析示腺苷負荷試驗心肌缺血範圍(人均缺血節段數)CSF組多于NCF組(1.06±0.77和0.91±0.80,t=-2.02,P＜0.05),少于P-CAG組(2.41±0.79,t=4.54,P＜0.001).靶心圖記分心肌缺血程度顯示CSF組大于NCF組(8.01±6.06和2.73±2.60,t=-2.07,P＜0.05),小于P-CAG組,但差異無統計學意義(14.07±12.77,t=1.44,P＞0.05).結論 腺苷負荷心肌灌註暘性顯像中部分患者伴有冠脈造影慢血流現象,這為有明顯胸痛癥狀但冠脈造影陰性的患者提供瞭診斷和治療依據.
목적 탐토선감부하99Tcm-갑양기이정기이정(MIBI)심기현상여관상동맥(간칭관맥)조영만혈류현상적관계.방법 44례환자균경관맥조영급선감부하99Tcm-MIBI심기혈류관주현상,분석비교관맥조영양성조(P-CAG)12례,관맥만혈류조(CSF)22례이급관맥정상혈류조(NCF)10례환자림상자료、선감심기부하현상개변、관맥조영결과여선감부하심기현상적관계.결과 채용방차분석、t검험혹x2검험비교.결과 3조림상자료(포괄년령、성별화위험인소:고혈압사、고지혈증급당뇨병발병솔)차이균무통계학의의(년령:t=0.27,0.54화0.59;성별:x2=0.92;위험인소:x2=1.23;P균＞0.05);CSF조관맥심기경사용전요법(TIMI)혈류정수명현다우NCF조(33.7±5.5화17.6±3.9,t=-9.58,P＜0.001).P-CAG조12례,선감부하심기현상양성솔100%(12/12);CSF조22례,양성솔77.3%(17/22);NCF조10례,2례양성.반정량파심도분석시선감부하시험심기결혈범위(인균결혈절단수)CSF조다우NCF조(1.06±0.77화0.91±0.80,t=-2.02,P＜0.05),소우P-CAG조(2.41±0.79,t=4.54,P＜0.001).파심도기분심기결혈정도현시CSF조대우NCF조(8.01±6.06화2.73±2.60,t=-2.07,P＜0.05),소우P-CAG조,단차이무통계학의의(14.07±12.77,t=1.44,P＞0.05).결론 선감부하심기관주양성현상중부분환자반유관맥조영만혈류현상,저위유명현흉통증상단관맥조영음성적환자제공료진단화치료의거.
Objective To investigate the relationship between myocardial ischemia and slow coronary flow phenomenon with 99Tcm-methoxyisobutylisonitrile (MIBI) adenosine myocardial perfusion SPECT imaging. Methods Forty-four patients were divided to three groups according to the result of coronary angiography(CAG). There were GAG-positive(P-GAG) (n=12),slow coronary flow (CSF) (n =22),and normal coronary flow (NCF) (n = 10). Results of adenosine myocardial perfusion imaging were compared among these three groups. Semi-quantitative visual scoring method was used to evaluate the myocardial perfusion:0 = normal,1 = mild decrease,2 = moderate decrease,3 = severe decrease,4 = defect. Statistical analysis was performed using variance analysis,t-test and x2-test. Results No significance was observed at age ( t =0.27,0. 54 and 0. 59),sex (x2 = 0. 92),hypertension,hyperlipemia and diabetes (x2 = 1.23,all P ＞ 0.05 ) among the three groups. A significantly higher frames of the coronary thrombolysis in myocardial infarction (TIMI) flow was noted in CSF than in NCF groups (33.7 ±5.5 vs 17.6 ±3.9,t = 9. 58,P ＜0. 001 ). The positive adenosine myocardial perfusion imaging rate were significant among these three groups with 100% (12/12) in P-CAG group,77.3% (17/22) in CSF group,and 20% (2/10) in NCF group. When using semi-quantitative visual scoring method,significantly higher average ischemia segments were noted in CSF group than in NCF group ( 1.06 ± 0.77 and 0. 91 ± 0.80,t = - 2. 02,P ＜ 0. 05 ),but was less than that in P-CAG group (2.41 ±0.79,t =4. 54,P ＜0.001 ). The degree of ischemia of CSF group was higher than that in NCF group ( 8.01 ± 6.06,and 2.73 ± 2.60,t = - 2.07,P ＜ 0.05 ) and was less than that in P-CAG group (14. 07 ±12. 77 ,t=1.44,P＞0. 05). Conclusion Slow coronary flow phenomenon can be detected by adenosine myocardial perfusion image to offer the evidence of diagnosis and treatment for the chest pain patients with negative coronary angiography results.
