99↑Tc^m-N-NOET负荷和延迟门控心肌灌注显像对高血压患者的临床价值  

The clinical value of 99↑Tc^m-N-NOET exercise and delayed myocardial perfusion imaging in patients with hypertension

作　　者：卫华[1] 李思进[1] 刘建中[1] 武志芳[1] 刘海燕[1] 胡光[1] 王进[1] 李清[1] 

机构地区：[1]山西医科大学第一医院核医学科,太原030001

出　　处：《国际放射医学核医学杂志》2010年第1期23-26,共4页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 探讨99↑Tc^m-双（N-乙氧基,N-乙基-二硫代氨基甲酸酯）氮化锝（99↑Tc^m-N-NOET）负荷和延迟心肌灌注显像（MPI）对高血压患者的临床应用价值.方法 对60例高血压患者和19例正常对照者进行99↑Tc^m-N-NOET负荷＋延迟MPI,并对MPI、运动心电图、心功能参数[舒张末期容积（EDV）、收缩末期容积（ESV）、左室射血分数（LVEF）]、△LVEF（LVEF支运动-LVEF延迟）及冠状动脉造影（CAG）结果进行相关分析.结果 ①高血压组60例患者中,22例（36.7%）运动中心电图阳性,16例（26.7%）运动中出现胸闷,13例（21.7%）运动中出现血压过度反应;对照组19例正常者中,2例（10.5%）运动心电图阳性,1例（5.3%）运动中出现胸闷,无运动中血压过度反应者.②高血压组MPI阳性率明显高于对照组（31.75% vs.5.30%,P〈0.05）.③高血压组运动和延迟的心功能参数[运动EDV=（79.75±29.10）ml,ESV=（28.82±15.73）ml,LVEF=（65.78±1.27）%;延迟EDV=（81.42±3.47）ml,ESV=（30.62±2.05）ml,LVEF=（64.20±9.70）%]与对照组[运动EDV=（79.63±21.65）ml,ESV=（27.37±10.71）ml,LVEF=（66.42±1.55）%;延迟EDV=（82.89±4.96）ml,ESV=（31.42±3.06）ml,LVEF=（63.16±7.54）%]均无统计学差异（运动EDV：t=0.161,ESV：t=0.112,LVEF：t=0.261;延迟EDV：t=0.276,ESV：t=0.197,LVEF：t=0.184,P〈0.05）,高血压组△LVEF为负值者有28例（46.7%）,对照组有4例（21.1%）,χ^2=3.929,P〈0.05.MPI阳性而△LVEF为负值者有11例（57.9%）,MPI阴性而△LVEF为负值者有12例（29.3%）,χ^2=4.501,P〈0.05.④高血压患者中19例行CAG,结果：11例异常,8例正常;行MPI结果：9例缺血,10例正常.两者比较无统计学差异（χ^2=0.25,P〉0.05）.99↑Tc^m-N-NOET MPI的灵敏度、特异度和准确率分别为72.7%、87.5%和78.9%.结论 ①99↑Tc^m-N-NOET负荷＋延迟MPI可用于诊断高血压患者是否伴有心肌缺血.②高血压患者的心功能储备降低,MPI阳性的高血压患者心脏�Objective To investigate clinical significance of the 99↑Tc^m-bis （N-ethoxy-N-ethyl-dithiocarbamato） nitridotechnetium（99↑Tc^m-N-NOET） exercise and delayed myocardial perfusion imaging （MPI） in hypertensive patients. Methods Sixty patients with hypertension and 19 normal subjects were carried out 99↑Tc^m-N-NOET exercise and delayed MPI, and analyzed the results of MPI, exercise electrocardiography （ECG）, cardiac function parameters end-diastolic volume（EDV）, end-systolic volume（ESV）, left ventricular ejection fraction（LVEF）, △ LVEF （LV EF exercis-LVEF delay） and coronary angiography（CAG）. Results ① Sixty patients with hypertension, 22 cases（36.7%）of exercise ECG were abnormal, 16 cases （26.7%）were the chest tightness in exercise, 13 cases （21.7%） were blood pressure excessive reaction in exercise; control group, 2 cases （10.5%） of exercise ECG were abnormal, 1 case （5.3%, 1/19） was chest tightness in exercise,no per-son was blood pressure response in excessive. ②The positive rate of myocardial perfusion in hyper tensive group was significantly higher than the control group （31.75% vs.5.30%, P〈0.05）. ③Cardial function parameters in hypertension group [exercise EDV =（79.75 ±29.10）ml, ESV =（28.82 ± 15.73）ml, LVEF =（65.78 ±1.27）%; delay EDV=（81.42±3.47）ml, ESV=（30.62±2.05）ml, LVEF=（64.20±9.70）%] and control group[exercise EDV=（79.63 ±21.65）ml, ESV=（27.37±10.71）ml, LVEF=（66.42±1.55）%; delay EDV=（82.89±4.96）ml,ESV=（31.42±3.06）ml, LVEF=（63.16 ±7.54）%] were no statistical difference（exercise EDV： t=0.161, ESV： t=0.112, LVEF： t=0.261; delay EDV： t=0.276, ESV： t=0.197, LVEF： t=0.184, P〉0.05）, △ LVEF〈0%, 28 cases （46.7%） in hypertension group, 4 cases （21.1%） in control group, χ2=3.929, P〈0.05; 11 cases （57.9%） in MPI positive group, 12 cases （29.3%） in MPI negative group, χ2=4.501, P〈0.05. ④Nineteen hypertension underwent CAG, 11 cases were abn

关 键 词：高血压 心肌灌注显像 99↑Tc^m-双(N-乙氧基 N-乙基-二硫代氨基甲酸酯)氮化锝 

分 类 号：R544[医药卫生—心血管疾病]