运动负荷^(201)铊单光子发射型计算机断层显像判断经皮冠状动脉腔内成形术后再狭窄的价值  

Clinical Value of Exercise ^(201)Tl Myocardial Single Photon Emission Computed Tomography in Detection of Restenosis after Successful Percutaneous Transluminal Coronary Angioplasty

作　　者：王丽娟[1] 赵卫华[1] 贾大林 曾定尹 山岸広幸 越智宏畅 

机构地区：[1]辽宁省沈阳市中国医科大学第一临床学院循环内科,110001 [2]日本大阪市立大学医学部附属病院

出　　处：《中国循环杂志》2000年第3期145-147,共3页Chinese Circulation Journal

摘　　要：目的 :探讨运动负荷 2 0 1铊 (2 0 1 Tl)单光子发射型计算机断层显像 (Ex- 2 0 1 Tl SPECT)判断经皮冠状动脉腔内成形术(PTCA)后再狭窄的价值。　　方法 :对 PTCA术后 3～ 6个月的 12 8例患者 (心绞痛 74例 ,陈旧性心肌梗塞 5 4例 )进行 Ex- 2 0 1 Tl SPECT及运动负荷心电图 (Ex- ECG)。将左心室划分为 9个节段 ,采用 4级评分法对 2 0 1 Tl分布进行视觉评价 ,比较延迟像与负荷像的核素分布。　　结果 :12 8例冠心病患者 ,Ex- 2 0 1 Tl SPECT判断冠状动脉再狭窄的敏感性及特异性分别为 79%、89% ,明显高于 Ex-ECG(Ex- ECG 为 5 9%、6 8% ,Ex- ECG 为 5 2 %、74% ) ;心肌梗塞患者的 Ex- 2 0 1 Tl SPECT敏感性明显高于 Ex- ECG (P<0 .0 1) ,其特异性无显著差别。冠状动脉再狭窄程度越重 (狭窄 <10 0 % ) ,其检出率越高。　　结论 :Ex- 2 0 1 Tl SPECT使心肌显像对判断 PTCA术后再狭窄具有较大的临床应用价值。Objective:To evaluate the clinical value of exercise 201 Tl myocardial single photon emission computed tomography(Ex 201 Tl SPECT) in detection of restenosis after successful percutaneous transluminal coronary angioplasty (PTCA). Methods:In 128 patients (74 angina pectoris,54 old myocardial infarction),Ex 201 Tl SPECT,a symptom limited exercise electrocardiogram (Ex ECG) and coronary angiography were performed at 3 to 6 months after successful PTCA.Left ventricle was divided into nine segments in the short axis and vertical long axis images and uptake of 201 Tl was evaluated by four score system (DS).The DS in the redistribution imaging was compared with that in exercise imaging. Results:Sensitivity and specificity of Ex 201 Tl SPECT for detecting coronary artery restenosis after PTCA were 79%,89% respectively in the 128 patients,and were higher significantly than that of Ex ECG(Ex ECG Ⅰ:59%,68%;Ex ECG Ⅱ:52%,74%).In patients with myocardial infarction,the sensitivity of Ex 201 Tl SPECT was significantly higher than that of Ex ECG Ⅱ( p <0 01),and there is no significant difference in the specificity.The more serious the degree of restenosis,the higher positive rate(restenosis<100%). Conclusions:The results conclude that Ex 201 Tl SPECT has practical clinical value to detect coronary artery restenosis after PTCA,and can provide basis for examination and treatment.

关 键 词：铊201 放射性核素显像 血管成形术 再狭窄 

分 类 号：R541.405[医药卫生—心血管疾病] R654.2[医药卫生—内科学]