CAJ | 학술논문

目的观察腺苷负荷心肌灌注显像对老年经皮冠状动脉介入治疗(PCI)患者疗效评估包括心肌血运恢复及心功能恢复情况。方法选择怀疑冠心病和已明确诊断老年冠心病患者，常规完成冠状动脉造影，53例行PCI，于PCI前、后6个月进行腺苷负荷心肌灌注显像检查，并同时进行心血管主要不良事件随访，完成随访40例。腺苷负荷心肌灌注显像把心肌分为16节段，计算核素扫描总积分及测定心功能。结果心肌扫描总积分与冠状动脉总狭窄指数呈正相关(r=0.675，P＜0.01);PCI后心肌扫描总积分与治疗前比较明显减低，分别为（2.2±2.3）与（4.5±1.9）分，差异有统计学意义(t=7.348，P＜0.01)；PCI术后心肌灌注改善总有效率86.8％(40/53);PCI术后左心室射血分数较术前明显改善，分别为(58.3±10.5)％与（53.8±10.3）％，差异有统计学意义(t=3.497，P＜0.01)。结论腺苷负荷心肌灌注显像作为一种无创的检测方法可以准确判定老年PCI术后血流恢复及心功能恢复情况，对老年人PCI术后疗效评价具有一定优势。
목적 관찰선감부하심기관주현상대노년경피관상동맥개입치료(PCI)환자료효평고포괄심기혈운회복급심공능회복정황。 방법 선택부의관심병화이명학진단노년관심병환자，상규완성관상동맥조영，53례행PCI，우PCI전、후6개월진행선감부하심기관주현상검사，병동시진행심혈관주요불량사건수방，완성수방40례。선감부하심기관주현상파심기분위16절단，계산핵소소묘총적분급측정심공능。 결과 심기소묘총적분여관상동맥총협착지수정정상관(r=0.675，P＜0.01);PCI후심기소묘총적분여치료전비교명현감저，분별위（2.2±2.3）여（4.5±1.9）분，차이유통계학의의(t=7.348，P＜0.01)；PCI술후심기관주개선총유효솔86.8％(40/53);PCI술후좌심실사혈분수교술전명현개선，분별위(58.3±10.5)％여（53.8±10.3）％，차이유통계학의의(t=3.497，P＜0.01)。 결론선감부하심기관주현상작위일충무창적검측방법가이준학판정노년PCI술후혈류회복급심공능회복정황，대노년인PCI술후료효평개구유일정우세。
Objective To evaluate the value of adenosine-stress myocardial perfusion imaging (MPI)in post-operation follow-up after the percutaneous coronary intervention(PCI) in the elderly.Methods There were patients (53 cases) underwent adenosine-stress MPI prior to and 6 months after PCI. Major adverse cardiovascular events (MACE) were followed. Left ventricular ejection fraction (LVEF) was analyzed in 40 cases. The image of the left ventricular myocardium was divided into 16 segments to calculate total defect score using a 4-grade assessment. Myocardial scintigrams were evaluated by calculating the summed adenosine-stress score and coronary angiography assessed by calculating the summed score of coronary artery stenosis.Results There was a significant correlation between the scores of coronary artery stenosis and adenosine-stress MPI scores (r=0.675,P＜0.01). Adenosine-stress MPI scores were obviously lower after PCI than before(2.2± 2.3 vs. 4.5±1.9,t= 7.348, P＜0.01); LVEF was significantly greater after PCI than pre-operation[(58.3±10.5 ) ％ vs. (53.8 ± 10.3) ％, t = 3.497, P＜0.01] and the effective rate for myocardial perfusion were 86.84 ％. Conclusions Adenosine stress MPI is a good noninvasive diagnostic method with high accuracy and plays an important role for evaluating recovery of myocardial perfusion and left ventricle function in the elderly patients after PCI.