腺苷负荷试验在^(99m)Tc-MIBI心肌灌注显像中不良反应的观察  

Adverse reaction of adenosine burden test in ^(99m)Tc-MIBI myocardial perfusion imaging

作　　者：冯雪凤[1] 贾支俊[1] 许守林[1] 郭万华[1] 

机构地区：[1]南京大学医学院附属鼓楼医院核医学科,南京210008

出　　处：《实用诊断与治疗杂志》2008年第1期24-26,81,共4页Journal of Practical Diagnosis and Therapy

摘　　要：目的:观察腺苷负荷试验在99mTc-甲氧基异丁基异腈(MIBI)心肌灌注显像中的不良反应。方法:对72例临床确诊或可疑冠心病患者,静脉注射腺苷90mg/30mL,剂量140μg/(kg.min)持续泵入至6min,注射过程中,行心电监测,观察患者的症状、血压和心率,于注射腺苷3min末,静脉注射核素显像剂99mTc-MIBI925MBq,1.5h后行心肌灌注断层显像。结果:在72例患者中,11.1%(8/72)无任何不适,88.9%(64/72)出现各种不良反应,其中胸部不适72.2%(52/72),头昏25.0%(18/72),其次为气短、心悸、皮肤潮红、麻木感和出汗,偶有恶心、呕吐、低血压和喉紧等。2例分别因血压和心率下降提前终止,1例达到目标心率4min终止。在腺苷注射3min末时,心率加快(P<0.01),收缩压降低(P<0.05),舒张压无变化(P>0.05)。在腺苷注射6min末时,心率加快(P<0.01),收缩压降低(P<0.01),舒张压降低(P<0.01)。在腺苷停止注射5min后,患者不良反应消失,心率,收缩压和舒张压已恢复基础水平。结论:腺苷负荷试验在99mTc-MIBI心肌灌注显像中不良反应很多,但多为轻微反应,并且于终止试验后不良反应迅速消失。Objective To observe the adverse reaction of adenosine burden test in ^99mTc-MIBI myocardial perfusion imaging.Methods A total of 72 inpatients were included in this study.Adenosine was infused intravenously at a rate of 140 μg/（kg·min） for 6 minutes.At the end of 3 minutes after adenosine infusion,925MBq of ^99mTc-MIBI was injected intravenously.In this process,the symptom,blood pressure and heart rate of patients were recorded.SPECT myocardial imaging acquisition was obtained at 1.5 hours after adenosine infusion.Results In 72 patients,11.1% patients had no symptom,88.9% had varied kinds of adverse reaction,consisted of chest complaint（72.2%）,dizziness（25.0%）,short breath,palpitation,skin aestus,insensible fleeling,sweating and so on.Two patients quitted the test because the blood pressure and the heart rate decreased,1 patient＇s heart rate reached the target at the end of 4 minutes.At 3 minutes and 6 minutes of adenosine infusion,the heart rate was increased（P〈0.01）,systolic pressure was dropped（P〈0.05）,however,diastolic blood pressure had no change.At the end of 5 minutes of stopping adenosine infusion,all adverse reaction disappeared,heart rate,contractive pressure and diastolic blood pressure returned to basal level.Conclusion Adenosine burden test in ^99mTc-MIBI myocardial perfusion imaging has a great deal adverse reaction,but it vanishes fast after stopping adenosine infusion.

关 键 词：心肌灌注显像 腺苷 心脏负荷试验 ^99MTC-MIBI 不良反应 

分 类 号：R817.4[医药卫生—影像医学与核医学]