腺苷负荷^(99m)Tc-MIBI心肌灌注显像诊断冠心病的应用价值  

Evaluation of ^(99m)Tc-MIBI Myocardial Perfusion Imaging with Intravenous Infusion of Adenosine in Diagnosis of Aoronary Artery Disease

作　　者：陈文新[1] 何品玉[1] 董惟誉[1] 周庆伟[1] 林志毅[1] 陈彩龙[1] 

机构地区：[1]福建省立医院核医学科,福州350001

出　　处：《福建医科大学学报》2006年第5期463-466,共4页Journal of Fujian Medical University

基　　金：福建省卫生厅青年科研基金资助项目(9618)

摘　　要：目的观察腺苷负荷试验心肌灌注显像诊断冠心病的准确性与安全性,评价其诊断冠心病的应用价值。方法对32例拟诊冠心病患者行腺苷负荷心肌灌注显像。腺苷注射液以140μg.kg-1.min-1速度经静脉泵持续注入,用药时间6 min。注射过程中行心电、血压监测,观察副反应;记录静息、用药3 min、注射终止时以及终止后5 min的心率、血压、12导联心电图;于用药3 min时注射99mTc-MIBI 925 MBq,1.5 h行心肌灌注断层显像。显像异常患者<48 h行静息显像。8例患者行冠状动脉造影。结果入选患者均达腺苷用药终止标准。腺苷注射3 min、用药终止时心率增快,与用药前比较有统计学意义(P<0.01);用药3 min、用药终止时收缩压均值较用药前减低,差别有统计学意义(P<0.05)。未发现严重低血压和严重心律失常者,且停药后5 min恢复至用药前静息水平(P>0.05)。负荷心肌显像共检出病变19例(59.4%),33个异常节段,以冠状动脉造影为参照标准,则腺苷负荷显像诊断冠心病的准确性为87.5%。结论腺苷负荷心肌灌注显像对诊断冠心病有较高的准确性和安全性,且无创伤性,具用重要的临床应用价值。Objective To evaluate the safety and diagnostic accuracy of pharmacologic stress of ^99mTechnetium-MIBI single-photon emission computed tomography（SPECT） with intravenous adenosine in patients with coronary artery disease. Methods The study group included 32 patients who were suspected of having coronary artery disease. All patients underwent ^99mTc-MIBI myocardial perfusion imaging with adenosine infusion at a rate of 140μg · kg^-1· min^-1 for 6 min. 20 mCi of ^99mTc-MIBI were injected 3 minutes after the start of adenosine infusion. The occurrence of cardiac and non-cardiac adverse effects was carefully monitored during and after intravenous adenosine infusion. Myocardial SPECT images were obtained 1.5 h later. Eight patients revealed abnormal imaging, ^99mTc-MIBI myocardial SPECT was repeated at 〈48 h . Results The adenosine infusion protocol was completed in all patients. Most of the patients had some peripheral hemodynamic changes： increase in heart rate（P〈0.01） and decrease in systolic blood pressure（P〈0.05）. The adverse effects were mild and transient. Adenosine myocardial perfusion imaging was abnormal in 19 patients（59.4%）. The diagnostic accuracy of adenosine ^99mTC- MIBI myocardial perfusion study for detecting coronary artery disease was 87.5%. Conclusion ^99mTechnetium-MIBI SPECT with intravenous adenosine is an accurate and safe technique for detecting coronary artery disease.

关 键 词：腺苷 体层摄影术 发射型计算机 单光子 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]