冠脉造影正常的II型糖尿病患者核素心肌灌注显像分析  

The analysis of myocardial perfusion tomography in non insulin dependent diabetes mellitus with normal coronary angiography

作　　者：张欣[1] 张延军[1] 解静慧[1] 杜雪梅[1] 郑平伟[1] 刘岩岩[1] 夏丽华[1] 朱毅[1] 

机构地区：[1]大连医科大学附属第一医院核医学科,辽宁大连116011

出　　处：《中国临床医学影像杂志》2004年第12期690-691,701,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨冠脉造影(CAG)正常的II型糖尿病(NIDDM)患者SPECT心肌负荷显像特点及临床价值。方法:应用99Tcm-甲氧基异丁基异腈(MIBI)负荷门控心肌灌注断层显像(MPT)定性与半定量记分法,比较18例CAG正常的NIDDM患者(A组)及15例正常对照组(B组)运动负荷?静息心肌显像特点。结果:①A组负荷状态下有16例(16?18,88.8%)共计38个节段出现心肌血流灌注异常(其中可逆性缺损占16个节段,部分可逆性缺损18个节段,固定性缺损4个节段);B组15例受检者中有2例共计3个节段存在血流灌注异常(均为评分1分的可逆性缺损),与A组比较两者心肌出现血流灌注异常的机率差异显著(38?162,3?135;χ2=26.15,P<0.001)。②A组、B组左室射血分数(LVEF)测定值分别为64.9%±7.8%、71.6%±5.2%(t=3.641,P<0.01),两组之间差异显著。结论:NIDDM患者即使CAG检查是正常的,负荷状态下多数仍存在心肌血流灌注异常,并伴有一定程度的左室射血功能减低。Objective To evaluate the feature and clinical significance of SPECT myocardial perfusion tomography(MPT) in non insulin dependent diabetes mellitus(NIDDM) with normal coronary angiography(CAG). Methods Qualitative and semi quantitative diagnosis from gated stress and rest 99Tcm sestamibi(MIBI) MPT were compared between 18 NIDDM and 15 normotensive controls(NC). Results ①The positive rate of MPT in NIDDM was obviously higher than that of NC which was 88.9%(1618) vs 13.3%(215) respectively. Most foci of MPT were reversible defects(1638) and partial reversible defects (1838). The positive rate of abnormal segments in NIDDM was obviously higher than that of NC(38162 3135 χ2=26.15 P<0.001). ②Analysis of heart functional data there was significant difference about LVEF between NIDDM and NC(64.9%±7.8% 71.6%±5.2% t=3.641 P<0.01). Conclusions Most NIDDM patients have stress MPT abnormal even without significant epicardial artery stenosis together with the systolic function of left ventricular slightly depressed.

关 键 词：糖尿病 非胰岛素依赖型 放射性核素显像 99M锝SESTAMIBI 

分 类 号：R587.1[医药卫生—内分泌] R814.43[医药卫生—内科学]