三磷酸腺苷负荷心肌灌注显像在女性冠心病患者诊断中的价值  

Value of adenosine triphosphate stress and rest nuclide myocardial perfusion imaging in diagnosis of female patients with coronary heart disease

作　　者：姜文平[1] 侯森[2] 林秋玉[2] 谷瓅[1] 赵红光[2] 

机构地区：[1]吉林油田总医院核医学科,吉林松原138006 [2]吉林大学第一医院核医学科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2016年第2期370-374,I0004,共6页Journal of Jilin University：Medicine Edition

基　　金：卫生部吴阶平医学基金资助课题(320675007127)

摘　　要：目的:评价三磷酸腺苷(ATP)负荷/静息核素心肌灌注显像(MPI)在女性冠心病(CHD)患者诊断中的价值。方法:回顾性分析47例疑似CHD女性患者的临床资料。所有患者均入院接受二日法ATP负荷/静息核素MPI和冠状动脉造影(CAG)检查,2项检查均在2周内完成,每项检查结果均有2名以上的主治医师共同阅片。以CAG结果为"金标准",评价MPI对CHD的诊断效能(灵敏度、特异度和准确度)。结果:与CAG结果比较,ATP负荷MPI对女性CHD患者的诊断灵敏度、特异度、准确度分别为81.3%(13/16)、77.4%(24/31)和78.7%(37/47);阳性预测值和阴性预测值分别为65.0%(13/20)和88.9%(24/27)。ATP负荷试验时不良反应的发生率为85.1%(40/47),无严重不良反应发生。结论:ATP负荷MPI对CHD患者具有较高的诊断效能,可作为女性CHD患者首选的无创性筛选与诊断心肌缺血的检查方法。Objective： To evaluate the value of adenosine triphophate （ATP） stress/rest nuclide myocardial perfusion imaging （MPI） in the diagnosis of female patients with coronary heart disease （CHD）. Methods： The clinical materials of 47 female suspected CHD patients were retrospectively analyzed, aged from 39 to 74 years, and the average age was （53.7＋6.3） years old. All patients were hospitalized and underwent two-day ATP stress and rest nuclide MPI and coronary angiography （CAG） in two weeks. The results and images of MPI and CAG were evaluated hy more than 2 attending physicians. Using CAG as the ＂gold standard＂, the diagnostic efficiency （sensitivity, specificity and accuracy） of MPI for CHD was evaluated. Results： Compared with CAG, the sensitivity, specificity and accuracy of ATP stress MPI in diagnosing the female CHD patients were 81.3% 13/ 16）, 77.4% （24/31） and 78.7% （37/47） individually; the positive predictive value and negative predictive value were 65.0% （13/20） and 88.9% （24/27）. There were no severe adverse effects in the ATP stress test and the incidence of adverse effects was 85.1%. Oonclusion： There is a highly diagnostic efficiency of ATP stress MPI in the CHD patients. It can be the first choice of examination methods for screening without injury and diagnosing the myocardial ischemia in the female patients.

关 键 词：三磷酸腺苷 心肌灌注显像 冠心病 女性 

分 类 号：R817.4[医药卫生—影像医学与核医学]