三磷腺苷负荷脑血流灌注显像的安全性探讨  

The safety study of adenosine triphosphate(ATP)stress cerebral blood flow imaging

作　　者：刘杰[1] 金超岭 续蕊 郑玉民[1] 刘蕾[2] 尹立杰[1] LIU Jie;JINChao-ling;XU Rui

机构地区：[1]中日友好医院核医学科,北京100029 [2]中日友好医院神经内科,北京100029

出　　处：《中日友好医院学报》2021年第6期336-338,343,共4页Journal of China-Japan Friendship Hospital

基　　金：中日友好医院院级课题(2015-1-QN-26)。

摘　　要：目的:探讨三磷腺苷(ATP)作为脑血流灌注显像负荷用药的安全性。方法:选取2015年11月~2020年1月在中日友好医院神经内科就诊的脑血管病患者82例,其中男59例,女23例。平均年龄61.8±11.2岁,体重69.7±9.8kg。ATP负荷脑试验中监测心电图及血压,观察、询问并记录患者的不良反应。结果:82例患者中未出现因不良反应而提前终止ATP负荷试验者。经脑血流灌注显像判断脑血流储备(CVR)减低52例(63.4%),余30例(36.6%)患者CVR良好。本组患者均存在一种或多种轻微的不良反应,主要表现为头晕、头痛、心悸,分别为59例(72%)、56例(68.3%)和66例(80.5%)。CVR减低患者多见于男性、吸烟及饮酒患者,显著高于女性、未吸烟及饮酒者(均P<0.05);且这些患者多合并高血压、高脂血症、糖尿病。CVR减低患者头痛、头晕症状比例较CVR良好患者显著增高(均P<0.05)。结论:ATP价格低廉,其作为脑血流灌注显像负荷用药安全性高、不良反应较轻,主要集中在头晕、头痛、心悸等方面,应用前景良好。Objective:To explore the safety of ATP(adenosine triphosphate)stressing test as the stress drug of cerebral blood perfusion imaging.Methods:From November 2015 to January 2020,82 patients with cerebrovascular disease were selected from the Neurology Department of China-Japan Friendship Hospital,including 59 males and 23 females.The average age was 61.8±11.2 years and the body weight was 69.7±9.8 kg.ECG and blood pressure were measured during ATP stressing test,and adverse reactions were observed,inquired and recorded.Results:Among the 82 patients,there was no case of early interruption of ATP stressing test due to adverse reactions.The CVRs(cerebrovascular reserve)of 52 patients(63.4%)were decreased in cerebral perfusion imaging,and 30 patients(36.6%)showed satisfactory CVRs.All the 82 patients had one or more mild adverse reactions,the main adverse reactions were dizziness,headache and palpitation,which were 72%(59/82),68.3%(56/82)and 56.1%(46/82),respectively.The patients with CVR reduction were more common in men.The patients with smoking and drinking habits were more likely to have CVR reduction(P<0.05),and most poor CVR patients have hypertension,hyperlipidemia and DM.Conclusion:Because of the less atrioventricular block incidence,using ATP as a stressing medicine in cerebral blood flow perfusion imaging has less adverse reaction and high safety.So it has a good application prospect for its safty and cost benefit.

关 键 词：三磷腺苷 负荷 脑血流灌注 不良反应 

分 类 号：R445.5[医药卫生—影像医学与核医学]