中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2011年
2期
97-100
,共4页
谢博洽%田月琴%郑黎晖%刘冰%杨敏福%沈锐%方纬%张晓丽%何作祥%孙晓昕
謝博洽%田月琴%鄭黎暉%劉冰%楊敏福%瀋銳%方緯%張曉麗%何作祥%孫曉昕
사박흡%전월금%정려휘%류빙%양민복%침예%방위%장효려%하작상%손효흔
腺苷%体层摄影术,发射型计算机,单光子%心电描记术%心律失常%心肌缺血%MIBI
腺苷%體層攝影術,髮射型計算機,單光子%心電描記術%心律失常%心肌缺血%MIBI
선감%체층섭영술,발사형계산궤,단광자%심전묘기술%심률실상%심기결혈%MIBI
Adnosine%Tomography,emission-computed,single-photon%Electrocardiography%Arrhythmia%Myocardial ischemia%MIBI
目的 评价腺苷负荷心肌灌注显像中患者的心电图变化.方法 回顾性分析2008年5月至12月完成腺苷负荷心肌灌注显像的641例患者腺苷药物负荷试验心电图变化和心肌灌注显像结果.统计学分析采用SAS 8.0软件,单因素分析采用t检验和χ2检验,多因素分析采用Logistic 回归分析.结果 腺苷注射前,641例患者中心电图正常436例(68.0%),心电图异常205例(32.0%).腺苷注射过程中新出现心律失常132例(20.6%,132/641),其中房性早搏39例(29.5%),室性早搏45例(34.1%),窦房阻滞8例(6.1%),一度房室传导阻滞7例(5.3%),二度Ⅰ型房室传导阻滞26例(19.7%),二度Ⅱ型房室传导阻滞6例(4.5%),三度房室传导阻滞1例(0.8%);需停药13例(9.8%).腺苷注射终止后新出现心律失常28例(4.4%,28/641),其中房性早搏16例(57.1%),室性早搏11例(39.3%),窦房阻滞1例(3.6%).641例患者腺负荷试验中共35例(5.5%)出现心电图ST段压低＞0.1 mV,39例(6.1%)予停药处理,无一例急性心肌梗死及猝死;心肌灌注显像结果:36例心肌缺血改变,8例心肌梗死改变.Logistic回归分析示,用腺苷药前、中、后心律失常并不增加出现心肌缺血及心肌梗死改变的风险[P=0.9613,比值比(OR)=0.982,95%可信区间(CI)0.471～2.046;P=0.9511,OR＜0.001,95%CI:＜0.001,＞999.999;P=0.9931,OR＜0.001,95%CI:＜0.001,＞999.999],并且腺苷注射过程中出现与未出现房室传导阻滞患者的阳性心肌灌注显像结果及ST段压低的发生率差异均无统计学意义(χ2=2.5298,0.5317,P均＞0.05).ST段压低＞0.1 mV的患者出现阳性心肌灌注显像结果的风险增加(P=0.0005,OR=5.608,95%CI2.110～14.905).结论 腺苷负荷试验过程中心电图异常发生率较高,但多为一过性,出现心律失常并不意味着有心肌缺血.
目的 評價腺苷負荷心肌灌註顯像中患者的心電圖變化.方法 迴顧性分析2008年5月至12月完成腺苷負荷心肌灌註顯像的641例患者腺苷藥物負荷試驗心電圖變化和心肌灌註顯像結果.統計學分析採用SAS 8.0軟件,單因素分析採用t檢驗和χ2檢驗,多因素分析採用Logistic 迴歸分析.結果 腺苷註射前,641例患者中心電圖正常436例(68.0%),心電圖異常205例(32.0%).腺苷註射過程中新齣現心律失常132例(20.6%,132/641),其中房性早搏39例(29.5%),室性早搏45例(34.1%),竇房阻滯8例(6.1%),一度房室傳導阻滯7例(5.3%),二度Ⅰ型房室傳導阻滯26例(19.7%),二度Ⅱ型房室傳導阻滯6例(4.5%),三度房室傳導阻滯1例(0.8%);需停藥13例(9.8%).腺苷註射終止後新齣現心律失常28例(4.4%,28/641),其中房性早搏16例(57.1%),室性早搏11例(39.3%),竇房阻滯1例(3.6%).641例患者腺負荷試驗中共35例(5.5%)齣現心電圖ST段壓低＞0.1 mV,39例(6.1%)予停藥處理,無一例急性心肌梗死及猝死;心肌灌註顯像結果:36例心肌缺血改變,8例心肌梗死改變.Logistic迴歸分析示,用腺苷藥前、中、後心律失常併不增加齣現心肌缺血及心肌梗死改變的風險[P=0.9613,比值比(OR)=0.982,95%可信區間(CI)0.471～2.046;P=0.9511,OR＜0.001,95%CI:＜0.001,＞999.999;P=0.9931,OR＜0.001,95%CI:＜0.001,＞999.999],併且腺苷註射過程中齣現與未齣現房室傳導阻滯患者的暘性心肌灌註顯像結果及ST段壓低的髮生率差異均無統計學意義(χ2=2.5298,0.5317,P均＞0.05).ST段壓低＞0.1 mV的患者齣現暘性心肌灌註顯像結果的風險增加(P=0.0005,OR=5.608,95%CI2.110～14.905).結論 腺苷負荷試驗過程中心電圖異常髮生率較高,但多為一過性,齣現心律失常併不意味著有心肌缺血.
목적 평개선감부하심기관주현상중환자적심전도변화.방법 회고성분석2008년5월지12월완성선감부하심기관주현상적641례환자선감약물부하시험심전도변화화심기관주현상결과.통계학분석채용SAS 8.0연건,단인소분석채용t검험화χ2검험,다인소분석채용Logistic 회귀분석.결과 선감주사전,641례환자중심전도정상436례(68.0%),심전도이상205례(32.0%).선감주사과정중신출현심률실상132례(20.6%,132/641),기중방성조박39례(29.5%),실성조박45례(34.1%),두방조체8례(6.1%),일도방실전도조체7례(5.3%),이도Ⅰ형방실전도조체26례(19.7%),이도Ⅱ형방실전도조체6례(4.5%),삼도방실전도조체1례(0.8%);수정약13례(9.8%).선감주사종지후신출현심률실상28례(4.4%,28/641),기중방성조박16례(57.1%),실성조박11례(39.3%),두방조체1례(3.6%).641례환자선부하시험중공35례(5.5%)출현심전도ST단압저＞0.1 mV,39례(6.1%)여정약처리,무일례급성심기경사급졸사;심기관주현상결과:36례심기결혈개변,8례심기경사개변.Logistic회귀분석시,용선감약전、중、후심률실상병불증가출현심기결혈급심기경사개변적풍험[P=0.9613,비치비(OR)=0.982,95%가신구간(CI)0.471～2.046;P=0.9511,OR＜0.001,95%CI:＜0.001,＞999.999;P=0.9931,OR＜0.001,95%CI:＜0.001,＞999.999],병차선감주사과정중출현여미출현방실전도조체환자적양성심기관주현상결과급ST단압저적발생솔차이균무통계학의의(χ2=2.5298,0.5317,P균＞0.05).ST단압저＞0.1 mV적환자출현양성심기관주현상결과적풍험증가(P=0.0005,OR=5.608,95%CI2.110～14.905).결론 선감부하시험과정중심전도이상발생솔교고,단다위일과성,출현심률실상병불의미착유심기결혈.
Objective To analyze alterations in electrocardiogram (ECG) of adenosine test in 99Tcm-MIBI myocardial perfusion imaging(MPI)SPECT study. Methods A total of 641 patients were in cluded in the study. The patients each underwent 99Tcm-MIBI MPI with adenosine test. The ECGs were taken before, during, and after adenosine infusion. Results In all, abnormal ECGs were found in 205(32.0%) patients. During adenosine infusion, 20.6%(132/641) of patients suffered from arrhythmia,29.5%(39/132) had atrial premature beats, 34. 1% (45/132) had premature ventricular beats, and 6. 1% (8/132) had sinoatrial block. In addition, 5.3% (7/132) had first-, 24.2% (32/132) had second-, and 0.8%(1/132) had third-degree atrioventricular block (AVB). After adenosine infusion, 4.4%( 28/641) of patients suffered from arrhythmia, 57.1% (16/28) had atrial premature beats, 39.3%(11/28) had premature ventricular beats, and 3.6% (1/28) had sinoatrial block. The perfusion images showed ischemia in 36 patients and infarction in 8 patients. Adenosine infusion was terminated in 39 patients (6. 1%) because of poorly tolerated side effects. However, no death or acute myocardial infarction occurred in the study. Conclusions Adenosine pharmacologic test for 99TcmMIBI MPI may result in relatively high incidence of arrhythmia in ECG monitoring.
