多巴酚丁胺与潘生丁^99mTc—MIBI心肌显像诊断冠心病价值的比较  

Comparisonofdobutamineanddipyridamoletechnetium┐99M┐MIBImyocardialimaginginthediag┐nosisofcoronaryarterydisease

作　　者：陈步星[1,2] 徐成斌[1,2] 杨志健[1,2] 王伟民[1,2] 田雅文[1,2] 高伯山 岳明纲[1,2] 

机构地区：[1]北京医科大学人民医院心内科 核医学科 [2]江苏省人民医院心内

出　　处：《中华心血管病杂志》1996年第5期351-355,共5页Chinese Journal of Cardiology

摘　　要：为比较多巴酚丁胺（Ｄｏｂｕ－ＥＣＴ）和潘生丁（Ｄｉｐｙ－ＥＣＴ）９９ｍＴｃ－ＭＩＢＩ心肌显像诊断冠心病的价值，以冠状动脉造影为标准，对２１０例拟诊与确诊冠心病患者行药物负荷９９ｍＴｃ－ＭＩＢＩ心肌显像，其中Ｄｏｂｕ－ＥＣＴ１００例，Ｄｉｐｙ－ＥＣＴ１１０例。诊断冠心病的敏感性，特异性，阳性预测值和阴性预测值，Ｄｏｂｕ－ＥＣＴ和Ｄｉｐｙ－ＥＣＴ（分别为９３．３％对９５．５％，８０％对８９．２％，９３．３％对９４．６％，８０％对９１．７％，Ｐ＞０．０５）无明显差异。诊断单支，双支，三支血管病变的敏感性，Ｄｏｂｕ－ＥＣＴ和Ｄｉｐｙ－ＥＣＴ（分别为９１．４％对９３％，９０．９％对１００％，１００％对１００％，Ｐ＞０．０５）无明显差异。诊断回旋支的敏感性Ｄｏｂｕ－ＥＣＴ低于Ｄｉｐｙ－ＥＣＴ（５０％对８２％，Ｐ＜０．０１）。对心肌梗塞后残余心肌缺血检出率和多支血管病变检出率，Ｄｏｂｕ－ＥＣＴ与Ｄｉｐｙ－ＥＣＴ类似（分别为７６％比７３％，８６％比８２％，Ｐ＞０．０５）。研究中无１例出现严重副作用。结果提示，Ｄｏｂｕ与Ｄｉｐｙ９９ｍＴｃ－ＭＩＢＩ心肌显像一样，用于诊断冠心病具有较高的敏感性和特异性，二者对于心肌梗塞后残余心?Tocomparethevalueofdobutamineanddipyridamole99mTc-MIBImyocardialimag-inginthediagnosisofcoronaryarterydisease(CAD),210patientswithcomfirmedorsuspectedCADunderwentpharmacologicstress99mTc-MIBImyocardialimaging,including100patientswithdobu-tamine(Dobu-ECT)and110patientswithdipyridamoletests(Dipy-ECT).Comparedwiththere-sultsofcoronaryangiography,theoveralsensitivity,specificity,positivepredictivityandnegativepredictivityfordetectingCADbetweenDobu-ECTandDipy-ECTwerenotdifferentsignificantly(93.3%vs95.9%,80%vs89.2%,93.3%vs94.6%and80%vs91.7%respectively,alP>0.050).Indiagnosingsingle-,double-andtriple-vesseldiseases,thesenesitivitybetweenDobu-ECTandDiPy-ECTwasnotsignificantlydiferenttoo(91.4%vs93.0%,90.9%vs100%and100%vs100%,respectively,alP>0.05).Inidentifyingthestenosisoftheleftcircumflex(LCX),thesensitivityofDobu-ECTwaslowerthanthatofDipy-ECT(50%vs82%,P<0.01).Inidentify-ingresidualischemiaandtwo-ortriple-vesseldiseaseaftermyocardialinfarction,thesensitivityofDobu-ECTandDipy-ECTwasalsosimilar(76%vs73%and86%vs82%respectively,bothP>0.05).Noserioussideefectswereobservedinthetwostudies.BothDobu-ECTandDipy-ECTaresafe,feasiblenon-invasivemethodswithhighsensitivityandspecificityfordiagnosingCAD,identify-ingthestenosesofLAD,LCXandRCA,anddetectingresidualischemiaaftermyocardialinfaction.Thus,theymaybeusedwidelyinsupplementingtheshortcomingofeachotherorofstressmyocardialimaginginthediagnosisofCAD.

关 键 词：多巴酚丁胺 潘生丁 心肌断层显像 冠心病 诊断 

分 类 号：R541.404[医药卫生—心血管疾病]