高血压病心肌灌注及硝酸甘油介入显像与室性心律失常关系的研究  

The relationship between ventricular arrhythmia and abnormal myocardial perfusion and nitroglycerin administration

作　　者：陈文新[1] 何品玉[1] 董惟誉[1] 郑云芳 梁爱武[1] 

机构地区：[1]福建省立医院核医学科,福州350001

出　　处：《中华核医学杂志》2000年第4期159-161,共3页Chinese Journal of Nuclear Medicine

基　　金：福建省卫生厅青年基金!资助项目 (961 8)

摘　　要：目的　探讨高血压病心肌显像异常的临床意义及与心律失常的关系。方法　对 88例高血压患者行99Tcm 甲氧基异丁基异腈心肌灌注断层显像 ,对其中 5 7例显像异常者再行硝酸甘油介入心肌显像。所有患者均行Holter检查 ,冠状动脉造影 31例。结果　运动和静息显像后仍有 6 4 8%患者灌注减低 ,6 0 2 %的灌注减低节段硝酸甘油介入显示有填充或不完全填充 ,提示合并冠心病。多因素逐步回归分析表明 ,室性心律失常与心肌灌注减低的程度及左室肥厚 (LVH)呈线性回归关系。结论　心肌灌注断层显像及硝酸甘油介入心肌显像能反映高血压患者是否合并冠心病 ,并与其他高血压性病理改变所致的灌注减低相区别。高血压合并冠心病及LVH是心律失常的重要病理基础。Objective To investigate the clinical significance of abnormal myocardial perfusion on the 99 Tc m MIBI scan and the relationship between perfusion defects and ventricular arrhythmia in patients with hypertension Methods 88 patients with hypertension underwent stress rest 99 Tc m MIBI myocardial perfusion SPECT Then, of the scan abnormal cases, 57 underwent nitroglycerin intervention 24 hour ambulatory electocardiographic monitoring was performed on all patients and coronary angiography on 31 patients Results Abnormal perfusion was found on rest 99 Tc m MIBI scintigraphy in 64 8% cases 59 of 98 (60 2%) perfusion defective segments showed complete or partial filling after nitroglycerin administration Multiple logistic regression analysis revealed that ventricular arrhythmia correlated with the occurrence of left ventricular hypertrophy (LVH), and showed a linear correlation between ventricular arrhythmia and perfusion defect degrees Conclusions Myocardial perfusion SPECT and administration of nitroglycerin can assess coronary flow and show perfusion abnormalities caused by microvascular diseases in hypertension or LVH Hypertension complicated by CAD and LVH plays an important role in the occurrence of various ventricular arrhythmia

关 键 词：高血压 心肌灌注 99TCM-MIBI 硝酸甘油 心律失常 

分 类 号：R544.1[医药卫生—心血管疾病] R817.42[医药卫生—内科学]