^99Tc^m-MIBI心肌灌注显像对代谢综合征患者并发冠心病的评价  

Clinical evaluation of ^99Tc^m-MIBI myocardial perfusion imaging for the detection of coronary artery disease in patients with metabolic syndrome

作　　者：田月琴[1] 魏红星[1] 郭新华[1] 郭风[1] 何作祥[1] 

机构地区：[1]中国医学科学院、中国协和医科大学阜外心血管病医院核医学科,北京100037

出　　处：《中华核医学杂志》2008年第4期241-243,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨核素心肌灌注显像对代谢综合征患者并发冠心病的诊断价值。方法回顾性分析251例[男179例，女72例，年龄（59±10）岁]代谢综合征患者^99Tc^m-甲氧基异丁基异腈（MIBI）心肌灌注显像的结果，与冠状动脉造影进行比较，计算^99Tc^m-MIBI心肌灌注显像诊断冠心病的灵敏度、特异性和准确性。结果在251例代谢综合征患者中，163例（65％）患者冠状动脉造影示有狭窄病变，^99Tc^m-MIBI心肌灌注显像检出心肌缺血或心肌梗死116例；88例冠状动脉造影阴性患者中，82例心肌灌注显像结果正常；^99Tc^m-MIBI心肌灌注显像诊断冠心病的灵敏度为71％（116／163），特异性为93％（82／88），阳性预测值为95％（116／122），阴性预测值为64％（82／129），准确性为79％（198／251）。诊断单支、双支和三支冠状动脉病变患者的灵敏度分别为58％（36／61），61％（22／36）和87％（57／66）。结论^99Tc^m-MIBI心肌灌注显像对检测代谢综合征患者有无并发冠心病有重要的应用价值。Objective Metabolic syndrome is a combination of medical disorders that consist of a collection of independent factors at risk of developing coronary artery disease. The purpose of this study was to evaluate the value of ^99Tc^m-methoxyisobutylisonitrile （MIBI） myocardial perfusion imaging for the diagnosis of coronary artery disease in patients with metabolic syndrome. Methods A total of 251 patients [ mean age （59± 10） years, 179 men, 72 women] were included in this study. All patients underwent exercise and rest ^99Tc^m-MIBI myocardial perfusion imaging and coronary angiography. Resnits Of the 163 patients with significant coronary artery stenosis, 116 showed abnormal ^99Tc^m-MIBI myocardial perfusion imaging; and among the 88 patients with normal coronary angiography, 82 showed normal myocardial perfusion imaging. The sensitivity, specificity and accuracy of ^99Tc^m-MIBI myocardial perfusion imaging for coronary artery disease detection were 71% （ 116/163 ）, 93% （82/88） and 79% （ 198/251 ）, respectively. The positive and negative predictive values were 95% （116/122） and 64% （82/129）, respectively. Conclusion ^99Tc^m-MIBI myocardial perfusion imaging has important clinical value for detecting coronary artery disease in patients with metabolic syndrome.

关 键 词：冠状动脉疾病 危险因素 体层摄影术 发射型计算机 单光子 MIBI 

分 类 号：R686[医药卫生—骨科学]