运动试验心肌显像正常者的预后评价  

Prognostic value of normal exercise myocardial perfusion imaging

作　　者：林景辉[1] 朱玫 吴树燕[2] 潘中允[1] 李琳[2] 茹仙古丽[3] 王彦福[1] 聂弢 杨虎[2] 童玲[2] 

机构地区：[1]北京医科大学第一医院核医学科,100034 [2]北京医科大学第一医院核心内科,100034 [3]新疆医学院第一附属医院

出　　处：《中华核医学杂志》1996年第1期8-10,共3页Chinese Journal of Nuclear Medicine

摘　　要：对运动试验心肌显像基本正常者进行随访以评价其预后。154例病人均行运动负荷心肌显像及运动 ECG 试验,其心肌显像基本正常。50例作了冠状动脉造影,4例证实为单支病变。显像后随访时间>1年(12～98个月)。均按Bayesian 分析法估算其心肌显像前后患冠心病的可能性。结果示心肌显像前估测患冠心病可能性为19%(M),显像后下降为13%,差异有显著性(U=6.0198,P<0.01)。在随访中仅观察到1例发生心脏事件,心脏事件发生率为0.2%/年。4例单支冠状动脉病变者无1例发生心脏事件。55例运动 ECG 阳性者也无1例发生心脏事件。心肌显像正常者,即使有冠状动脉病变,或冠心病可能性大,或运动 ECG 阳性,其预后均良好。这从一个侧面表明心肌显像的重要性和可靠性。PURPOSE To assess the prognostic implications,patients with a normal exercise myocardial imaging were fol- lowed up.METHODS 54 patients underwent exercise myocardial perfusion imaging and exercise ECG test.The images of all of them were normal.Coronary arteriography was performed in 50 patients.Among them 4 patients had single vessel lesion.Follow- up period of all the patients was>1 year (12～90 Mo.).Likelihood of coronary artery disease (CAD,CAD LK) was estimated pre and after test by Bayesian analysis.RESULTS Mean of the pretest CAD LK was 19% and after test decreased to 13%.The difference between the CAD LK pre-and after test was significant(U=6.0 198,P<0.01).During the follow-up period cardiac event (CE) occured in only one patient.The CE rate was 0.2% per year.No CE occurred in the 4 patients with CAD and in the 55 patients with positive exercise ECG.CONCLUSIONS The data confirm that a normal stress myocardial imaging predicts an ex- cellent prognosis even in patients with CAD or a high pretest CAD LK or a positive exercise ECG.

关 键 词：放射性核素 心肌显像 预后 

分 类 号：R817.42[医药卫生—影像医学与核医学]