G-MPI测定心肌灌注缺损区占比与心肌梗死介入术后左心功能的关系及预后预测价值  

The relationship between the proportion of myocardial perfusion defect area measured by G-MPI and the left ventricular function after interventional myocardial infarction and its prognostic value

作　　者：代燕燕[1] 王福华[2] 王瑞鹃[3] DAI Yanyan;WANG Fuhua;WANG Ruijuan(CT Room of Chengde Central Hospital,Chengde Hebei 067000,China)

机构地区：[1]承德市中心医院CT室,河北承德067000 [2]承德市中心医院心内科,河北承德067000 [3]承德医学院附属医院,河北承德067000

出　　处：《中国急救复苏与灾害医学杂志》2022年第11期1405-1408,1434,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2020年度河北省医学科学研究课题计划(编号:20200179)。

摘　　要：目的分析静息门控心肌灌注SPECT显像(G-MPI)测定心肌灌注缺损区占比与急性心肌梗死(AMI)介入术后左心功能的关系及预后预测价值。方法选取2019年2月—2021年2月承德市中心医院接受经皮冠状动脉介入治疗(PCI)的AMI患者82例,行静息G-MPI检查,检测术后1周、4周心肌灌注缺损区占比、左心功能指标[左室射血分数(LVEF)、左室舒张末期容量(LVEDV)、左室收缩末期容量(LVESV)]水平,并依据术后6个月患者是否发生主要不良心血管事件(MACE)分为MACE组(n=21)、非MACE组(n=61)。统计比较两组一般资料、术后1周、4周心肌灌注缺损区占比、左心功能指标(LVEF、LVEDV、LVESV)水平,观察心肌灌注缺损区占比与左心功能指标相关性,探讨心肌灌注缺损区占比对AMI介入术后MACE发生的预测价值,分析AMI介入术后MACE发生有关影响因素。结果MACE组病变支数多于非MACE组,术后1周、4周心肌灌注缺损区占比、LVEDV、LVESV水平高于非MACE组,LVEF水平低于非MACE组(P<0.05);相关性分析可知,AMI患者术后1周、4周心肌灌注缺损区占比与LVEF水平呈负相关,与LVEDV、LVESV水平呈正相关(P<0.05);绘制受试者工作特征(ROC)曲线显示,术后1周、4周心肌灌注缺损区占比预测AMI介入术后MACE的曲线下面积(AUC)均较高,尤以术后4周最高,为0.836;回归分析发现,术后1周、4周心肌灌注缺损区占比为AMI介入术后MACE发生的重要影响因素(P<0.05)。结论G-MPI测定心肌灌注缺损区占比与AMI介入术后左心功能密切相关,且对患者预后MACE发生具有良好预测价值,可为临床诊治提供一定参考。Objective To analyze the relationship between the proportion of myocardial perfusion defect area measured by gated myocardial perfusion SPECT imaging(G-MPI)and the left ventricular function after acute myocardial infarction(AMI)intervention and its prognostic value.Methods A total of 82 patients with AMI who received percutaneous coronary intervention(PCI)in our hospital from February 2019 to February 2021 were selected for resting G-MPI examination.Ratio,left ventricular function index[left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)]level,and based on whether the patient has major adverse cardiovascular diseases 6 months after surgery Events(MACE)were divided into MACE group(n=21)and non-MACE group(n=61).The general information of the two groups,the proportion of myocardial perfusion defect area at 1 and 4 weeks after surgery,and the levels of left ventricular function indexes(LVEF,LVEDV,LVESV)were compared,and the correlation between the proportion of myocardial perfusion defect area and left ventricular function indexes was observed.The predictive value of the proportion of myocardial perfusion defect area to the occurrence of MACE after AMI intervention,and the related factors of MACE after AMI intervention were analyzed.Results The number of lesions in the MACE group was more than that in the non-MACE group.The proportion of myocardial perfusion defects,LVEDV and LVESV levels were higher than the non-MACE group at 1 and 4 weeks after the operation,and the LVEF level was lower than the non-MACE group(P<0.05);The analysis showed that the proportion of myocardial perfusion defect area in AMI patients was negatively correlated with the level of LVEF at 1 and 4 weeks after surgery,and was positively correlated with the levels of LVEDV and LVESV(P<0.05);The receiver operating characteristic(ROC)curve showed that the proportion of myocardial perfusion defect area at 1 week and 4 weeks after surgery predicts that the area under the cur

关 键 词：静息门控心肌灌注SPECT显像 心肌灌注缺损区占比 急性心肌梗死 左心功能 预后 

分 类 号：R542.22[医药卫生—心血管疾病]