腺苷心肌灌注断层显像诊断老年人冠心病的价值  

The diagnostic value of adenosine myocardial perfusion single photon emission computed tomography in elderly patients with coronary artery disease

作　　者：贾淑杰[1] 王南晔[1] 王曦之[1] 米树华[1] 

机构地区：[1]首都医科大学附属北京安贞医院特需病房,100029

出　　处：《中华老年医学杂志》2009年第10期812-815,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨腺苷负荷试验锝-甲氧基异丁基异腈（99mTc-MIBI）心肌灌注单光子发射计算机断层显像（ECT）诊断老年人冠心病的价值。方法53例无心肌梗死病史的老年冠心病待查患者，年龄60～78岁，平均（65．5±6．5）岁。将ECT和冠状动脉造影（CAG）结果进行对照。结果ECT对CAG阳性冠心病诊断的敏感性为73．7％，特异性90．9％，阳性预测值为94．3％，阴性预测值为80．0％，准确性指数为62．3％。结果显示，腺苷ECT对左前降支、回旋支、右冠状动脉检出的特异性分别为90．9％、85．7％、100％，阳性预测值分别为73．5％、77．3％、72．0％。结论腺苷是一种较强的血管扩张剂，对心血管系统有多重作用。其与导管技术、核素心肌灌注显像等技术结合可用于冠心病的诊断。腺苷介入心肌灌注断层显像是一种无创、方便、费用低的检查方法，对老年冠心病的诊断、指导治疗和判断预后有重要的意义。Objective To evaluate the diagnostic value of adenosine stress 99mTc-MIBI myocardial perfusion single photon emission computed tomography （ECT）in elderly patients with coronary artery disease （CAD）. Methods Fifty-three patients aged ≥60 years without the history of myocardial infarction were included in the research. The average age of the patients was （65.5 ± 6.5） years （60-78 years old）. All patients underwent adenosine stress 9mTc - MIBI myocardial perfusion single photon ECT and coronary angiography （CAG） within 2 months, and the results were compared. Results Compared with CAG, the sensitivity, specificity, positive predictive value, negative predictive value and accurate index of ECT were 73.7 %, 90.9 %, 94.3 %, 80.0 % and 62.3 %, respectively. The specificity for left anterior descending artery, left circumflex artery and right coronary artery of ECT were 90.9 %, 85.7 % and 100 %, respectively, and the positive predictive values were 73.5%, 77.3 % and 72.0%, respectively. Conclusions Adenosine is a strong vasodilator and it has multiple effects on cardiovascular system. Combination of angiocardiography and myocardial perfusion imaging can be used in diagnosis of coronary artery disease. ECT is a noninvasive, convenient and low cost method and plays an important role in diagnosing, directing treatment and judging prognosis of CAD in the elderly patients.

关 键 词：冠状动脉疾病 腺苷 冠状血管造影 

分 类 号：R686[医药卫生—骨科学]