门控心肌SPECT显像测量冠心病低度可能性患者心功能参数参考值范围及其影响因素分析  

Influence of gender, age and weight on the cardiac functional parameters determined by gated myocardial SPECT imaging in patients with low-likelihood coronary heart disease

作　　者：李家俊[1,2] 郭风[2] 田月琴[2] 何作祥[2] 

机构地区：[1]清华大学第一附属医院放射科,北京100016 [2]北京协和医学院、中国医学科学院阜外医院核医学科,100037

出　　处：《中华核医学与分子影像杂志》2017年第7期404-409,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：“十二五”国家科技支撑计划项目（2011BAI11802）

摘　　要：目的 获取冠心病低度可能性患者G-MPI心功能参数的参考范围,并分析性别、年龄和体质量对其的影响.方法 选取疑诊冠心病但冠心病低度可能性的门诊患者175例[男89例,年龄（48.3±10.7）岁;女86例,年龄（49.8±10.4）岁],在2008年2月至2011年4月间均行99Tcm-MIBI负荷G-MPI,测定左心室EDV、ESV、EF,对符合正态分布的数据采用正态分布法确定参考范围,偏态分布的数据采用百分位数法,并采用多元直线回归分析法分析性别、年龄和体质量对参数值的影响.2组间比较采用两样本t检验,不同年龄组间心功能参数比较采用单因素方差分析.结果 男性EF值下限为50%,EDV、ESV上限为112 ml、49 ml;女性EF值下限54%,EDV、ESV上限为77 ml、30 ml.男性EDV、ESV分别为（75.8±18.3）和（27.1±10.9） ml,均显著高于女性的（53.3±11.7）和（14.3±7.9） ml（t值：935、8.59,均P〈0.01）;男性EF低于女性：（65.1±7.6）%和（74.7±10.0）%（t=-6.92,P〈0.01）,女性小心脏比例为76%（65/86）.多元回归分析结果表明性别、年龄是EF、ESV的预测因子,体质量也是心室容积预测因子;按年龄大小将患者分成≤40岁,41~49岁,≥50岁组,男性不同年龄组间EDV、ESV、EF差异均无统计学意义（F值：1.106、0.954、1.029,均P〉0.05）;女性不同年龄组间EDV差异无统计学意义（F=2.408,P〉0.05）,ESV、EF差异有统计学意义（F值：5.010、6.229,均P〈0.05）.结论 G-MPI测量不同性别、年龄冠心病低度可能性患者的心功能参数有差异,男性和女性的参数随年龄增加而变化的趋势不同.Objective To derive reference limits of cardiac functional parameters （CFP） determined by gated myocardial SPECT imaging, and to analyze the influence of gender, age and weight on CFP. Methods One hundred and seventy-five consecutive outpatients （89 males with age of （48.3±10.7） years and 86 females with age of （49.8±10.4） years） were defined as patients with low-likelihood coronary heart disease （LCHD）. All patients underwent adenosine or exercise stress 99Tcm-MIBI G-MPI from February 2008 to April 2011. The EF, EDV and ESV of the left ventricle were measured by quantitative gated SPECT （QGS） software. The reference limits were derived by means of Gaussian distribution or percentiles. The influence of gender, age and weight on CFP was analyzed by multiple regressions for linear models. Two-sample t test was used to analyze data of 2 groups. Parameters between different age groups were compared by one-way analysis of variance. Results The lower reference limit of EF for males was 50%, the upper limit of EDV and ESV was 112 ml and 49 ml respectively. For females, the corresponding reference limits were 54%, 77 ml and 30 ml. Men had higher EDV, ESV （EDV： （75.8±18.3） ml vs （53.3±11.7） ml, t=9.35, P〈001; ESV： （27.1±10.9） ml vs （14.3±7.9） ml, t=8.59, P〈0.01） and lower EF than women （（65.1±76）% vs （74.7±10.0）%, t=-6.92, P〈0.01）. The incidence of small hearts in women was 76%（65/86）. The gender and age was the primary and secondary predictors of both of EF and ESV, while the body weight was a significantly third predictor for cardiac volume. Patients were dived into different age （≤40 years, 41-49 years, ≥50 years） groups. For males, EDV, ESV and EF were not significantly different among the different age groups （F values： 1.106, 0.954, 1.029, all P〉0.05）. For females, EDV was not different （F=2408, P〉005）, while ESV and EF were significantly different among 3 groups （F values： 5.010, 6.229, both P〈0.05�

关 键 词：冠状动脉疾病 心室功能 心肌灌注显像 体层摄影术 发射型计算机 单光子 99M锝甲氧基异丁基异腈 

分 类 号：R541.4[医药卫生—心血管疾病] R817.4[医药卫生—内科学]