药物与运动核素心肌灌注显像不良反应的临床分析  

Analysis of adverse responsis of drug and exersise myocardial perfusion imaging

作　　者：崔建和[1] 谭维琴[1] 崔晴[1] 吴曼青[1] 仝宇梭[1] 李天智[1] 

机构地区：[1]南京医科大学附属淮安第一医院核医学科,江苏省223300

出　　处：《江苏医药》2013年第1期59-61,共3页Jiangsu Medical Journal

摘　　要：目的比较腺苷负荷试验与运动负荷试验在99mTC-甲氧异丁基异腈(MIBI)核素心肌灌注显像中的不良反应。方法 2460例临床确诊或可疑冠心病患者做负荷心肌灌注显像,其中504例(A组)药物负荷采用静脉注射腺苷90mg/30ml,剂量140μg.kg-1.min-1,持续泵入至6min,于注射腺苷3min末,静脉注射核素显像剂99mTC-MIBI 20mci(740MBq),1.5h后行心肌灌注断层显像;1956例(B组)采用常规运动试验。结果 A组发生严重不良反应(心绞痛、窦性心动过缓)而终止试验的发生率为3.8%(19/504),轻度不良反应可完成试验的患者为73.0%(368/504),仅有轻微不良反应或无任何不适而顺利完成试验者为23.2%(117/504)。均低于B组的4.3%(84/1956)、65.8%(1287/1956)和29.9%(585/1956)。结论与运动负荷相比,腺苷心肌药物负荷试验不良反应发生率较低,可安全用于不能进行运动负荷的患者。Objective To compare the adverse responsis of adenosine stress test and exercise radionuclide myocardial perfusion imaging with ^99mTC-methoxy-isobutyl isonitrile（MIBI） myocardial perfusion imaging. Methods A total of 2,460 patients with confirmed or suspected coronary artery disease（CAD） was assgined into two groups of A（504 cases, received drug stress） and B（1956 cases, received conventional exersise）. The patients in group A were intravenously injected adenosine 90 mg/30 ml,followed by infusion of adenosine 140μg·kg^-1·min^-1 for 6 min. At the end of 3 min of adenosine infusion, radionuclide imaging agent 99mTC-MIBI 20 mci （740 MBq） was injected and myocardial perfusion SPECT was performed 1. 5 h later. Results The incidences of serious adverse response（such as angina, sinus bradycardia, the test interrupted）, miled adverse response（the test complited） and minor adverse response（the test completed successfully） were 3.8 %, 73 % （368/504） and 23. 2% （117/504） in group A, respectively, which were lower than 4. 3% （84/1956）, 65.8% （1287/1956） and 29.9% （585/1956） in group 13. Conclusion Compared to exercise test, adenosine stress radionuclide myocardial perfusion imaging has lower incidence of adverse responses and can be used safely in the oatients who can not torerate exercise.

关 键 词：腺苷 运动试验 核素心肌灌注显像 

分 类 号：R445[医药卫生—影像医学与核医学]