定量核素心肌显像对冠状动脉内支架术后疗效的评价及与定量冠状动脉造影的相关性研究  

Quantitative and comparative study on nuclide myocardial perfusion image before and after implanting intracoronary stents

作　　者：刘良福[1] 胡大一[2] 尹传贵[3] 王铁[2] 王振英[3] 贾三庆[2] 刘键[3] 

机构地区：[1]山东省临沂市人民医院心内科 [2]首都医科大学附属北京红十字朝阳医院 [3]山东省临沂市人民医院

出　　处：《中国心血管杂志》2002年第1期9-11,共3页Chinese Journal of Cardiovascular Medicine

基　　金：山东省科委自然科学基金;编号 971195 70 1

摘　　要：目的　观察冠状动脉造影 (CAG)与核素心肌组织血流灌注显像 (SPECT)的相关性及用 SPECT对冠状动脉内支架植入术后的疗效评价。方法　于冠心病 (CAD)患者 CAG之后 ,放支架之前利用血管造影机自配电脑分析软件 ,对病变血管直径狭窄和面积狭窄百分比进行自动分析 ;对冠状动脉内支架植入术前、术后 1周、术后半年 ,分别做静息、潘生丁负荷 SPECT检查。结果 5 1例 CAG血管直径狭窄 (76 .16 % )、面积狭窄 (90 .37% )与术前静息 SPECT血流灌注损害程度 (6 3.5 0 % )的相关系数分别为 r=0 .2 5 4、r=0 .176 ,存在一定的相关性 ;血管狭窄程度、血管狭窄面积与术前静息SPECT血流灌注损害面积 (71.17% )的相关系数分别为 r=0 .2 91、r=0 .32 7,存在一定的相关性。 5 0例术后 1周静息血流灌注损害程度 (4 5 .46 % )明显低于术前静息血流灌注损害程度 (6 3.5 0 % ) ,P<0 .0 0 1;2 1例术后半年血流灌注损害程度 (4 3.73% )明显低于术前静息血流灌注损害程度 (6 0 .87% ) ,P<0 .0 0 1。 5 0例术后 1周静息血流灌注损害面积 (5 7.2 2 % )明显低于术前静息血流灌注损害面积 (71.17% ) ,P<0 .0 0 1;2 1例术后半年血流灌注损害面积 (5 4.6 7% )明显低于术前静息血流灌注损害面积 (70 .2 1% ) ,P<0 .0 5。冠状动脉内支架植?Objective To observe the correlation between nuclide myocardial perfusion image(SPECT) and coronary angiography(CAG),and apply SPECT to assessment of the efficacy after coronary artery stents. Methods The stenosis diameter and area of sick vessels were quantitatively analyzed in 51 coronary artery disease(CAD) patients with blood vessel angiography machine and its intrinsic software after CAG and before implanting intracoronary stents. Rest and persantine exercise SPECT were performed in 51 CAD patients within one week before and after coronary artery stents and at half year(21 cases)after the procedure. And the degree and area of blood flow deficit were quantitatively analyzed with SPECT and its intrinsic software. Results The stenosis diameter of the vessels of the 51 patients was 76.16% and the stenosis area was 90.37% in CAG. The pre-procedure blood flow deficit degree at rest was 63.50% in SPECT. The correlation between the stenosis diameter and blood flow deficit degree was 0.254 and the correlation between the sttenosis area and blood flow deficit degree was 0.176, being rectilineally positive. At rest , the correlations between stanosis diameter and area of the vessels in CAG and blood flow deficit area in SPECT were 0.291 and 0.327 respectively, being rectilineally positive. The blood flow deficit degree of the 50 patients was respectively63.50%?45.46%, and 43.73%(21 cases) before procedure, at one week and half year after procedure. The blood flow deficit area at rest was respectively 71.17% and 57.22% before procedure and at one week after procedure (P<0.001). At rest, the blood flow deficit area of the 21 patients was 70.21% and 54.67% before procedure and at half year after procedure (P<0.05). The therapeutic effect after coronary artery stents was significant. In the 25 patients,there was no significant difference in blood flow deficit degree and area between rest and persantine exercise SPECT at one week after procedure. Conclusions Both kinds of techniques to evaluate blood flow deficit degre

关 键 词：冠状动脉造影 冠状动脉内支架术 SPECT 疗效 

分 类 号：R817.4[医药卫生—影像医学与核医学]