心肌灌注显像在PTCA支架术疗效判定和预后评估中的价值  

Prognostic value of myocardial perfusion tomographic imaging in patients after percutaneous transluminal coronary angioplasty plus stent

作　　者：宋人和[1] 孙福成[2] 姚稚明[1] 屈婉莹[1] 郑建国[1] 赵洪山[1] 

机构地区：[1]北京医院核医学科,100730 [2]北京医院心内科,100730

出　　处：《中华核医学杂志》2005年第1期22-23,共2页Chinese Journal of Nuclear Medicine

基　　金：中央保健委员会保健科研基金资助项目 (0 0 4)

摘　　要：目的　探讨心肌灌注显像对经皮冠状动脉腔内成形术 (PTCA)支架术疗效判定和预后评估的价值。方法　 75例行PTCA支架术患者 ,术后 3～ 1 2个月内行运动或药物负荷心肌灌注断层显像 ,其中 4 1例有术前显像对照。术后随访 1 3～ 98个月。结果　 4 1例患者术后心肌灌注改善率为73 1 7%;75例术后显像为正常、可逆性缺损或固定性缺损患者间 ,心脏事件发生率整体差异有极显著性 (P <0. 0 0 1 ) ,其中可逆性缺损与正常和固定性缺损患者间发生率差异均有显著性 (P <0. 0 1 7) ;生存分析依术后显像结果不同 ,无心脏事件概率曲线整体分布差异有显著性 (P <0 . 0 5 ) ,其中可逆性缺损与正常和固定性缺损患者间曲线分布差异均有显著性 (P <0 .0 5 )。结论　心肌灌注显像在PTCA支架术后疗效判定和预后评估中有应用价值。Objective To study the prognostic value of myocardial perfusion tomographic imaging in patients after percutaneous transluminal coronary angioplasty(PTCA)plus stent. Methods Seventy five patients underwent 99 Tc m methoxyisobutylisonitrile (MIBI) stress rest myocardial perfusion tomographic imaging (6.91±2 99) months after PTCA. They were then followed up for (41.71±20.00) months, and unstable angina pectoris, acute myocardial infarction, cardiac death and revascularization for cardiac events were recorded during follow up. Results Twenty five patients had cardiac events during follow up. And the cardiac event rate in patients with normal and fixed defects(5.9%, 16.7%)was significantly lower than that in those with reversible defects(52.5%, χ 2=10.94, P <0.017; χ 2=6.57, P <0.017). Survival analysis showed that the time free of cardiac event in patients with reversible defects was significantly shorter than in those with normal and fixed defects ( χ 2=7.37, P =0.0066; χ 2=6.28, P =0.012), and the mean time free of cardiac event after PTCA was (33.8±5.0) months. Conclusion The presence of reversible defects on post PTCA cardiac imaging predicts a higher cardiac event rate, the myocardial perfusion tomography imaging after PTCA is valuable for predicting the prognosis of patients after PTCA plus stent.

关 键 词：患者 疗效判定 心肌灌注显像 预后评估 术后 缺损 正常 显著性 结论 差异 

分 类 号：R541.4[医药卫生—心血管疾病]