CAJ | 학술논문

目的：研究腺苷负荷心肌灌注显像（MPS）与冠状动脉血管造影（CAG）的准确性及两者联合应用在评价冠状动脉病变及心肌缺血情况中的价值。方法对32例临床疑诊冠心病的患者先予静脉泵注腺苷注射液[剂量为0．14mg/（kg·min）]6 min，注射3 min时静脉注入核素显像剂99m Tc-MIBI925 MBq，1 h后行心肌灌注断层显像，若显像异常，次日行静息心肌灌注显像。所有患者2周内行冠状动脉血管造影术检查。将腺苷负荷心肌灌注显像与冠状动脉造影结果进行对比分析，评价冠状动脉病变及心肌缺血情况。结果32例患者中，14例冠状动脉造影显示为冠状动脉狭窄性病变，其中单支病变7例，二支病变4例，三支病变3例，腺苷负荷心肌灌注显像12例为阳性，2例阴性；18例冠状动脉造影显示未见明显狭窄，其中4例为壁冠状动脉，2例为冠状动脉慢血流，腺苷负荷心肌灌注显像为14例阴性，4例为阳性。腺苷负荷心肌灌注显像诊断冠状动脉阻塞性病变的敏感性为85．71％，特异性为77．78％，阳性预测值为75％，阴性预测值为87．5％，准确性为81．25％。结论腺苷负荷心肌灌注显像与 CAG结果具有较好的一致性，两者联用能充分了解冠状动脉病变及心肌缺血情况，有利于临床治疗的选择。
목적：연구선감부하심기관주현상（MPS）여관상동맥혈관조영（CAG）적준학성급량자연합응용재평개관상동맥병변급심기결혈정황중적개치。방법대32례림상의진관심병적환자선여정맥빙주선감주사액[제량위0．14mg/（kg·min）]6 min，주사3 min시정맥주입핵소현상제99m Tc-MIBI925 MBq，1 h후행심기관주단층현상，약현상이상，차일행정식심기관주현상。소유환자2주내행관상동맥혈관조영술검사。장선감부하심기관주현상여관상동맥조영결과진행대비분석，평개관상동맥병변급심기결혈정황。결과32례환자중，14례관상동맥조영현시위관상동맥협착성병변，기중단지병변7례，이지병변4례，삼지병변3례，선감부하심기관주현상12례위양성，2례음성；18례관상동맥조영현시미견명현협착，기중4례위벽관상동맥，2례위관상동맥만혈류，선감부하심기관주현상위14례음성，4례위양성。선감부하심기관주현상진단관상동맥조새성병변적민감성위85．71％，특이성위77．78％，양성예측치위75％，음성예측치위87．5％，준학성위81．25％。결론선감부하심기관주현상여 CAG결과구유교호적일치성，량자련용능충분료해관상동맥병변급심기결혈정황，유리우림상치료적선택。
Objective To assess the accuracy and feasibility of adenosine stress myocardial perfusion scintigraghy(MPS)for the di-agnosis ofcoronary artery disease(CAD).Methods A total of32 suspected coronary artery disease patients mean age (64.3 ±11.6)years, 22 men,10 women were recruited in this study.Adenosine was infused intravenously at a rate of o.14mg/kg/min for 6 minutes.At the end of 3 minute of adenosine infusion,925MBq of 99mTc-MIBI was injected intravenously.SPECT myocardial imaging acquisition was obtained 1 hour after adenosine infusion.If it was abnormal,the next day resting myocardial perfusion imaging was performed.Coronary angiography was performed in all patients.Results Fourteen patients had significant coronary artery stenosis and 18 had normal coronary angiography.Adeno-sine myocardial perfusion imaging was abnormal in 12 out of the 14 patients with significant coronary artery stenosis(sensitivity,85.71%). Fourteen out of the 18 patients with normal angiography had a normal adenosine myocardial perfusion imaging (specificity,77.78%).The positive predictive value and negative predictive value of adenosine 99mTc-MIBI myocardial perfusion imaging for detection of coronary ar-tery disease was 75%and 87.5%,respectively.Conclusion Adenosine myocardial perfusion imaging is probably an accurate method for de-tecting coronary artery disease and myocardial viability and is of value for patients with coronary disease to choose appropriate therapeutic strategies.