^(99m)锝—甲氧基异丁基异腈门控心肌灌注显像在冠心病预后评估中的价值  

Prognostic Value of ^(99m)Tc-Sestamibi Gated Myocardial Perfusion Imaging in Coronary Artery Disease Patients

作　　者：徐海燕[1] 李殿富[1] 冯建林[2] 程旭[2] 李建华[2] 

机构地区：[1]南京医科大学第一附属医院心脏科核心脏病专业组,江苏省南京市210029 [2]南京医科大学第一附属医院核医学科,江苏省南京市210029

出　　处：《中国循环杂志》2009年第3期174-177,共4页Chinese Circulation Journal

摘　　要：目的:探讨99m锝—甲氧基异丁基异腈(99mTc-MIBI)门控心肌灌注显像(G-MPI)在冠心病预后评估中的价值。方法:连续性收集接受静息和负荷99mTc-MIBI G-MPI的疑诊冠心病患者1 345例,回顾性分析其中完成随访的1 250例患者的临床、冠状动脉造影及G-MPI资料,用COX回归、Kaplan-Meier生存曲线分析。结果:G-MPI变量:负荷灌注总积分(3.8±6.1,x2=67.25),左心室射血分数(0.667±0.097,x2=42.26),灌注积分差(1.1±3.0,x2=21.09)为心脏事件的独立预测因子,P均<0.01。Kaplan-Meier生存曲线分析发现随负荷灌注总积分分值的下降患者生存率也明显下降,不同负荷灌注总积分值患者的生存率曲线间差异有统计学意义(x2=93.25,P<0.01),左心室射血分数≤0.5与>0.5患者生存曲线间差异有统计学意义(x2=14.9,P<0.01)。结论:负荷灌注总积分、灌注积分差和左心室射血分数对冠心病患者的预后评估有很好的价值。Objective： To determine the long-term prognostic value of ^99mTc-sestamibi （MIBI） Gated myocardial perfusion imaging（ G- MPI）in patients with coronary artery disease. Methods： A total of 1345 consecutive symptomatic coronary artery disease patients who underwent ^99mTc-MIBI G-MPI were studied. 1250 patients were followed-up by telephone interview, the median follow-up time was 26.7 ± 13.6 months. Events were defined as cardiac death, nonfatal myocardial infarction and revascularization by coronary artery bypass graft or percutaneous coronary artery intervention. Results： Cox regression analysis indicated that summed stress score （3. 8 ± 6. 1 ,x^2 = 67.25 ）, summed different score （ 1.1 ± 3.0 ,x^2 = 21.09 ） and left ventricular ejection fraction （LVEF） （0. 667 ± 0. 097, x^2 = 42. 26 ） were independent predictive factors of cardiac events （P 〈 0.01 ）. Kaplan-Meier analysis indicated that cardiac event free survival was significantly lower in the patient with LVEF≤50%. Conclusion： In Patients with symptomatic coronary artery disease, the summed stress score, summed rest score, summed different score and LVEF had prognostic value, and low LVEF indicated worse prognosis.

关 键 词：门控心肌灌注显像 冠状动脉疾病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]