^(99m)Tc-NOET和^(99m)Tc-MIBI门控心肌灌注显像在冠状动脉性心脏病诊疗和预后中的价值  

Value of ^(99m)Tc-NOET and ^(99m)Tc-MIBI GSPECT in the diagnosis,treatment and prognosis of coronary artery disease

作　　者：程艳[1] 李思进[1] 李险峰[1] 武志芳[1] 刘海燕[1] 

机构地区：[1]山西医科大学第一医院核医学科,山西太原030001

出　　处：《中国介入影像与治疗学》2009年第4期345-348,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：太原市大学生创新基金(07010718)

摘　　要：目的评价99mTc-NOET静息门控断层心肌灌注显像(GSPECT)对冠状动脉性心脏病(CAD)的诊断价值和对经皮冠状动脉腔内成形术(PTCA)及支架置入术后疗效的临床价值。方法首先,对70例疑似CAD的受检者行99mTc-NOET(NOET组1)或99mTc-MIBI(MIBI组1)静息GSPECT,并于1周内行冠状动脉造影;然后,对确诊的53例CAD患者PTCA及支架置入术前、术后1、3、6个月分别行NOET(NOET组2)或MIBI(MIBI组2)静息GSPECT。结果NOET组1和MIBI组1诊断CAD的灵敏度、特异性差异无统计学意义。NOET组2和MIBI组2比较:①NOET组2PTCA术后1、3、6个月心肌血流改善分别为59.29%、64.60%和66.37%,MIBI组2为20.35%、55.10%和61.22%;②PTCA术前、术后两组间心功能参数、临床事件的发生率之间差异无统计学意义。结论同99mTc-MIBI比较,99mTc-NOET对CAD的诊断、PTCA术后疗效的判定及观察临床事件发生率均有较大临床应用价值。Objective To predict the value of 99mTc-NOET gated myocardial perfusion SPECT imaging （GSPECT） in detecting coronary artery disease （CAD） and the theraputic effect of percutaneous transluminal coronary angioplasty （PTCA）. Methods First, 70 patients suspected of CAD underwent 99mTc-NOET （group NOET1） or 99mTc-MIBI （group MIBI1） rest GSPECT and coronary angiography （CAG） was performed within 1 week after GSPECT. Second, 53 patients with CAD underwent 99mTe-NOET （group NOET2） or 99mTc-MIBI （group MIBI2） rest GSPECT before and 1, 3 and 6 months after PTCA and/or stent treatment. Results The sensitivity and specificity had no difference between group NOET1 and MIBI1 in detecting CAD. Comparison of group NOET 2 and MIBI 2 ： ①59.29%, 64.60% and 66.37% of the abnormal myocardial segment was improved in group NOET2.1, 3 and 6 months after PTCA, while 20. 35%, 55.10% and 61.22% respectively in group MIBI2 ; ②There was no difference of the incidence of clinical events and the myocardial function parameters before and after PTCA in group NOET2 and MIBI2. Conclusion Compared with 99mTc-MIBI, 99mTc NOET has a greater clinical value for CAD diagnosis, PTCA efficacy and observation of the clinical events incidence.

关 键 词：双[N-乙氧基 N-乙基(二硫代氨基甲酸脂)氮化锝](Ⅴ) 99M锝甲氧基异丁基异腈 门控断层心肌灌注显像 血管成形术 经腔 经皮冠状动脉 冠状动脉性心脏病 

分 类 号：R541.4[医药卫生—心血管疾病] R817.4[医药卫生—内科学]