三磷酸腺苷二钠负荷心肌灌注显像在冠心病诊治中的临床应用  

Clinical application of mycardial perfusion imaging with adenosine triphosphate pharmacologic stress in diagnosis of coronary artery disease

作　　者：朱传明[1] 杨淑贞[1] 邱进[1] 许秀坤[1] 李辉[1] 

机构地区：[1]北京航天总医院,100076

出　　处：《实用医技杂志》2013年第6期594-596,共3页Journal of Practical Medical Techniques

基　　金：北京航天总医院卫生科技自主创新和普及推广项目(2011-113)

摘　　要：目的评价三磷酸腺苷二钠(ATP)负荷心肌灌注显像试验在冠状动脉粥样硬化性心脏病(冠心病)诊治中的临床应用价值。方法 152例患者行ATP负荷心肌灌注显像(MPI),24 h后行静息心肌灌注显像。随后其中82例行冠状动脉造影(CAG),与ATP负荷心肌灌注显像结果进行对比、分析,并对这些患者进行1年以上的随访。结果MPI诊断冠心病的灵敏度、特异性和准确度分别为91%、78%和88%。MPI诊断单支、2支、3支病变的阳性率分别为87%、91%和100%,MPI诊断2支和3支病变阳性率高于单支病变(P<0.05)。诊断前降支、回旋支及右冠状动脉病变阳性率分别为95%、87%和94%。在ATP负荷MPI过程中,轻度不良反应发生率为62%,随访1年以上,MPI阴性的患者无心脏恶性事件发生。结论 ATP负荷MPI可以替代运动负荷试验,对冠心病诊断的灵敏度、准确度较高,特异性一般。MPI对CAG检查处于临界病变的患者具有重要的意义。Objective To evaluate the value of the clinical application of mycardial perfusion imaging （MPI） with adenosine triphosphate stress in diagnosis of coronary artery disease （CAG）. Methods One hundred and twenty-two patients were underwent stress MPI with adenosine triphosphate and underwent rest MPI 24 h later. Eighty-two patients also were underwent CAG. Compared with the results of stress MPI with adenosine triphosphate disodium, and all patients were followed up more than one year. Results The sensitivity, specificity and predictive accuracy of adenosine triphosphate stress MPI in diagnosis of coronary artery disease were 91%, 78% and 88%. The positive diagnostic rate of MPI with single, two and three branch are 87%, 91% and 100%, Compared with single branch lesion, the positive findings at two branch and three branch lesion were high （P〈0.05）. With anterior descending artery, circumflex branch and right coronary artery disease were 95%, 87% and 94%. 62% of the patients had various kinds of adverse effects, most of them were mild. Only one patient required aminophyline. Conclusion It is shown that stress MPI with adenosine triphosphate is a safe and feasible technique for detecting coronary artery disease in patients unable to perform the exercise test. And it plays an important role in the clinical evaluation of CHD.

关 键 词：腺苷三磷酸 冠状动脉疾病 冠状动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病]