正常冠脉的老年高血压病人99mTc-tetrofosmin负荷心肌灌注断层显像异常的临床意义  

The Clinical Significance of Abnormal 99m-Tc-tetrofosmin Myocardial Perfusion Tomography in Elderly Patients with Hypertension

作　　者：侍作胜[1] 王跃涛[2] 杨丽[3] 李明哲[3] 

机构地区：[1]江苏省徐州市第四人民医院心内科,江苏徐州221009 [2]江苏省徐州市第四人民医院核医学科,江苏徐州221009 [3]江苏省徐州市第四人民医院老年病科,江苏徐州221009

出　　处：《高血压杂志》2002年第5期424-426,共3页Chinese Journal of Hypertension

摘　　要：目的　研究心肌灌注显像异常对冠状动脉造影 (CAG)正常的老年高血压病人的临床意义。方法　应用99mTc tetrofosmin负荷与静息心肌灌注断层显像 (MPT)定性方法 ,以及侧壁 室间隔计数比值 (L S)和负荷L S与静息L S之再比值 ,比较了 2 7例CAG正常的老年高血压病人与 2 1例血压正常的对照者的结果。结果　①老年高血压组MPT阳性率为 6 3% ,显著高于对照组的 9 5 % ,P <0 0 1,而且以可逆性缺损为主 ,伴有少数反向填充 ;其心绞痛和心律失常发生率明显高于对照组。②老年高血压组与对照组相比 ,负荷L S与静息L S之再比值明显降低 ,P <0 0 5。③老年高血压组MPT阳性病人负荷L S与静息L S之再比值低于MPT阴性病人P <0 0 1。④MPT异常分布于各个节段 ,大多数无明显心肌肥厚表现。结论　心肌灌注显像异常可以发生在CAG正常、有或无心肌肥厚的老年高血压病人中。Objective To evaluate the clinical significance of abnormal myocardial perfusion tomography (MPT) in the elder hypertensive patients with normal coronary angiography. Methods The average counts ratio of lateral to septal segments (L/S) and the ratio of stress L/S to rest L/S from stress and rest 99 mTc tetrofosmin myocardial perfusion tomography(MPT), were compared between hypertensive patients (HP) and normotensive controls(NC). Every risk factor and related indexes in patients with positive MPT were compared with the results of patients with negative MPT. Results ① The positive rate of MPT in HP was obviously higher than that of NC ( 63% vs 9.5%). Focul reversible defects (RD) was the most frequent finding.\ Few of them accompanied with reverse reversible defects (RRD). Elder HP had more angina pectoris and arrhythmia. ② The ratio of stress L/S to rest L/S in elder HP was lower than that of NC ( P <0 05).③ The ratio of stress L/S to rest L/S in the patients with positive MPT was significantly decreased compared with that with negative MPT ( P <0 01). ④ The abnormal defects of MPT in elder HP were found in segments of left ventricle in the patients most of them without left ventricular hypertrophy. Conclusions Abnormal MPT may exist in the elder HP with normal coronary angiography with or without left ventricular hypertrophy.

关 键 词：正常冠脉 高血压 99m Tc-tetrofosmin负荷心肌灌注断层显像 老年人 诊断 

分 类 号：R544.1[医药卫生—心血管疾病]