^(99m)Tc-MIBI门控心肌灌注显像短暂性缺血性扩张比值在无症状2型糖尿病患者心肌损害中应用价值研究  

Diagnostic value of transient ischemic dilation index on ^(99m)Tc-MIBI gated myocardial perfusion imaging in asymptomatic type 2 diabetic mellitus

作　　者：郝珊瑚 武晓丹 王治国 战莹 刘凤敏 张国旭 HAO Shan-hu;WU Xiao-dan;WANG Zhi-guo;ZHAN Ying;LIU Feng-min;ZHANG Guo-xu(Department of Nuclear Medcine,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院核医学科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第11期1276-1278,共3页Clinical Journal of Medical Officers

基　　金：辽宁省自然科学基金(2012225019)

摘　　要：目的探讨^(99m)Tc标记的甲氧基异丁基异腈(^(99m)Tc-MIBI)运动/静息门控心肌灌注显像短暂性缺血性扩张(TID)比值对无症状2型糖尿病患者心肌损害的诊断价值。方法选取自2011年2月至2013年2月在北部战区总医院确诊的2型糖尿病患者53例为糖尿病组,另选取同期在我院进行健康体检的34名志愿者为健康组。两组研究对象均接受两日法^(99m)TcMIBI运动/静息门控心肌灌注显像,17节段评分模型计算总负荷评分评价左心室各壁段缺血情况,根据总负荷评分将糖尿病组53例患者分为心肌缺血组(n=21)与无心肌缺血组(n=32)。采用Emory Cardiac Toolbox软件定量分析并比较各组研究寻象的TID比值。结果健康组中不同性别间TID比值比较,差异无统计学意义(t=0.352,P>0.05)。糖尿病组中,心肌缺血组TID比值为(1.22±0.24),无心肌缺血组TID比值为(1.08±0.16),两组间比较,差异有统计学意义(t=2.541,P<0.05)。以1.23为截断值,糖尿病心肌缺血组心肌缺血检出率为66.7%(14/21),无心肌缺血组中检测出TID阳性率为25.0%(8/32)。结论以1.23为TID比值的正常上限值,是发现无症状2型糖尿病患者心肌缺血的有效方法 ,是对心肌灌注显像的有效补充。Objective To investigate the normal value of transient ischemic dilatation（TID）in stress/rest ^99mTc -MIBI gated myocardial perfusion imaging and its diagnostic value of asymptomatic type 2 diabetic mellitus.Methods A retrospective study was performed on 53 cases of patients with type 2 diabetics mellitus（diabetic group）who were admitted from February 2011 to February 2013,another 34 healthy volunteers were in the healthy group.Patients in both groups received 99m Tc -MIBI motor/resting gated myocardial perfusion imaging with a 2-day method.The 17-segment scoring model calculated the total load score to evaluate the ischemia in each segment of the left ventricle.All 53 patients in the diabetic group were divided into the myocardial ischemia group（ n =21）and the non-myocardial ischemia group（ n =32）according to the total load score.Emory Cardiac Toolbox software was used to quantitatively analyze and compare the TID ratio of patients in each group.Results There was no statistically significant difference（ t =0.352, P 〉0.05）in the comparison of TID ratios between different genders in the healthy group.In the diabetic group,TID ratio in the myocardial ischemia group was （1.22±0.24）and that in the non-myocardial ischemia group was（1.08±0.16）.The difference was statistically significant（ t =2.541, P 〈0.05）.The detection rate of myocardial ischemia in the diabetic myocardial ischemia group was 66.7%（14/21）,and the positive rate of TID was 25.0%（8/32）in the group without myocardial ischemia.Conclusion The normal upper limit of TID ratio of 1.23 is an effective method to detect myocardial ischemia in asymptomatic type 2 diabetic patients,which is an effective supplement to myocardial perfusion imaging.

关 键 词：2型糖尿病 门控心肌灌注显像 心肌缺血 ^99MTC 甲氧基异丁异腈 

分 类 号：R817[医药卫生—影像医学与核医学] R587[医药卫生—放射医学]