定量门控^(201)T1心肌显像对冠心病患者的预后价值  

Prognostic value of gated ^(201)Tl myocardial perfusion SPECT imaging in patients with coronary artery disease

作　　者：李自成[1] 陈小明[1] 徐浩[2] 

机构地区：[1]暨南大学附属第一医院心内科,广州510630 [2]暨南大学附属第一医院核医学科,广州510630

出　　处：《中华核医学杂志》2006年第4期219-221,共3页Chinese Journal of Nuclear Medicine

基　　金：广东省重点科技基金(99M04604G)

摘　　要：目的研究定量门控 ^(201)Tl 心肌显像对冠心病患者预后评估及冠心病治疗方案选择的价值。方法对84例患者进行静息和运动负荷 ^(201)Tl 门控心肌灌注 SPECT 显像,并随访(32.92±16.77)个月。对心肌灌注图像进行评分(1～4分),计算总负荷评分(SSS)、总静息评分(SRS)和总差值分(SDS=SRS-SSS)、负荷左室射血分数(EF)值和静息 EF 值。结果随访中9例发生心脏事件,年发生率为3.90%。SSS、SDS、SRS 以及 EF 值均是心脏事件的独立预测因素(P<0.005)。Cox比例风险回归分析示 SSS 是心脏事件的最强预测因素。根据患者的负荷后 EF 值、SDS 等可将患者分为低危、中危和高危组。结论应用定量门控 ^(201)Tl 心肌显像可以对冠心病患者进行正确的预后评估,并可指导选择治疗方案。SSS 是心脏事件的最强预测因素。Objective To study the prognostic value of gated ^201Tl myocardial perfusion SPECT imaging in patients with coronary artery disease and assessment of therapy strategy for the individual patient. Methods Eighty-four patients underwent rest and exercise stress ^201Tl gated myocardial perfusion SPECT imaging and were followed up for （32.92 ± 16.77） months. Images were studied using 17 segments and 1 to 4 scoring. Global summed stress score （SSS）, summed rest score （SRS） and summed difference score （SDS =SSS- SRS） were also calculated. Post-stress and rest ejection fraction （EF） were automatically measured. Results Nine cardiac events occurred （ 3.90% per year）. SSS, SDS, SRS and EF were the independent predictors of cardiac events （ P 〈 0.005 ）. Cox regression analysis showed that SSS was the best predictor of cardiac events, Integration of the post-stress EF and SDS yielded effective stratification of patients： low-, intermediate-, and high-risk subgroups. Conclusions Gated ^201Tl myocardial perfusion SPECT imaging can provide prognostic assessment for the patients with coronary artery disease and guide in selection of therapeutic strategy. Among all of the indices SSS is the best predictors of cardiac events.

关 键 词：冠状动脉疾病 体层摄影术 发射型计算机 单光子 铊放射性同位素 预后 

分 类 号：R541.4[医药卫生—心血管疾病]