不同腺苷输注时间的负荷^(99)Tc^m-MIBI心肌灌注显像对冠心病心肌缺血评价的比较  

Comparison of different adenosine infusion time by use of ^(99)Tc^m-MIBI myocardial perfusion imaging for coronary artery disease

作　　者：江素芳[1] 彭旭兰[1] 梁宏伟[1] 刘炯[1] 高桂珠[1] 

机构地区：[1]山西医科大学第二医院核医学科,山西太原030001

出　　处：《中国医学影像技术》2007年第11期1706-1708,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价4min腺苷负荷试验心肌灌注显像对冠心病心肌缺血的临床应用价值,并与传统6min负荷试验进行了对比研究。方法将研究对象按性别、年龄、冠心病的严重程度(依据冠状动脉造影结果)及合并症等进行配对,分为4min腺苷负荷组(4min组)和6min腺苷负荷组(6min组),每组32例。两组病例均经肘静脉用注射泵持续注入腺苷,剂量为0.14mg.kg-1.min-1,用药时间为4min和6min,于注射腺苷3min末,分别从肘静脉注入99Tcm-MIBI740MBq。腺苷负荷心肌灌注显像在注射显像剂后1.5h进行,隔日进行静息心肌灌注显像。结果①4min组和6min组腺苷负荷心肌显像对冠心病心肌缺血的敏感性、特异性、准确率分别为89%、80%、88%和92%、83%、91%,两组比较P均>0.05。②4min组和6min组不良反应总的发生率分别为78%和88%,两率及组间各不良反应发生率比较差异无显著性。结论4min腺苷负荷心肌灌注显像对冠心病心肌缺血有较高的诊断价值,可达到6min腺苷负荷试验的诊断效能;且因用药时间短,患者易耐受。Objective To assess the clinical value of four-minute adenosine infusion ^99Tc^m-MIBI myocardial perfusion imaging for coronary artery disease（CAD）,in comparison with six-minute infusion.Methods The patients were matched and divided into four-minute adenosine infusion and six-minute adenosine infusion,each protocol had 32 patients.In two groups,adenosine was infused at a rate of 0.14 mg·kg^-1·min^-1 intravenously for four minutes and six minutes.At the end of three minute of adenosine infusion,740 MBq ^99Tc^m-MIBI was injected intravenously.SPECT myocardial imaging acquisition was obtained 1.5 hours after adenosine infusion,rest myocardial perfusion imaging would be performed following day.Results ①In four-minute and six-minute protocols,the sensitivity,specificity,diagnostic accuracies of CAD were 89%,80%,88% and 92%,83%,91%,respectively（P〉0.05）.② General side effects occurred in 78% of the patients in four-minute group and in 88% of the patients in the six-minute group.The incidence of side effects in the two groups was not significantly different.Conclusion Four-minute adenosine infusion,in combination with perfusion tomography,has high clinical value and similar diagnostic efficacy for myocardial ischemia of CAD with the six-minute protocol,and is accepted easily by patients because of its abbreviated infusion.

关 键 词：冠状动脉疾病 腺苷 放射性核素显像 

分 类 号：R543.3[医药卫生—心血管疾病] R817.4[医药卫生—内科学]