建立低可能性稳定性冠心病患者CZT SPECT负荷门控心肌灌注显像的左心室功能参数正常参考值  

Establishment of the normal reference values of left ventricular function parameters evaluated by CZT SPECT stress gated myocardial perfusion imaging in low-likelihood of stable coronary artery disease

作　　者：孟晶晶[1] 焦建[1] 解小芬[1] 牟甜甜[1] 常智 李珺奇[1] 师志勇 王彦琳 张爽[1] 贠明凯 米宏志[1] 张晓丽[1] Meng Jingjing;Jiao Jian;Xie Xiaofen;Mou Tiantian;Chang Zhi;Li Junqi;Shi Zhiyong;Wang Yanlin;Zhang Shuang;Yun Mingkai;Mi Hongzhi;Zhang Xiaoli(Department of Nuclear Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院核医学科,北京100029

出　　处：《中华核医学与分子影像杂志》2023年第3期144-149,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：扬帆计划重点医学专业(重点培育专业)(ZYLX202110)。

摘　　要：目的拟建立低可能性稳定性冠状动脉粥样硬化性心脏病(SCAD)患者的碲锌镉(CZT)SPECT负荷门控心肌灌注显像(G-MPI)的左心室功能参数正常参考值。方法回顾性收集2022年3月至2022年8月间于首都医科大学附属北京安贞医院行CZT SPECT运动负荷或药物负荷G-MPI的疑诊SCAD患者348例[男146例、女202例,年龄(58±10)岁]。定量门控SPECT(QGS)分析获得左心室舒张末期容积(EDV)、收缩末期容积(ESV)、左心室射血分数(LVEF),EDV和ESV分别经体表面积(BSA)校正后获得EDV指数(EDVI)和ESV指数(ESVI)。采用两独立样本t检验、单因素方差分析及Mann-Whitney U检验分析数据,采用多元线性回归分析影响EDV、ESV、EDVI、ESVI和LVEF的因素。结果共314例低可能性SCAD患者[男128例、女186例,年龄(58±10)岁]和34例正常对照(NC)者[男18例、女16例,年龄(55±10)岁],2组不同性别患者的临床特征和左心室功能参数差异均无统计学意义(z值:-1.74~-0.02,t值:-1.16~1.17,均P>0.05)。以95%CI为低可能性SCAD患者的左心室功能参数界值,女性和男性的EDV、ESV、EDVI、ESVI上限分别为84和111 ml、30和44 ml、47和54 ml/m^(2)、17和21 ml/m^(2),LVEF的下限分别为58%和55%。低可能性SCAD患者女性的EDV[(58±13)和(77±17)ml]、ESV[(16±7)和(26±9)ml]均小于男性(t值:10.65、10.35,均P<0.001),而LVEF高于男性[(72±7)%和(67±6)%;t=-6.23,P<0.001]。性别相同的不同年龄组间左心室功能参数差异均无统计学意义(F值:0.12~2.19,均P>0.05)。多元线性回归分析发现性别和体质量是左心室EDV、ESV和LVEF的影响因素(β值:-0.380~0.358,均P<0.05)。结论建立了CZT SPECT低可能性SCAD患者负荷G-MPI的左心室功能参数正常参考值。左心室EDV、ESV和LVEF存在性别差异,女性EDV、ESV小于男性,而LVEF高于男性。在临床实践中要考虑性别对左心室功能参数的影响。Objective To establish the normal reference value of left ventricular function parameters by cadmium-zinc-tellurium(CZT)SPECT stress gated myocardial perfusion imaging(G-MPI)in low-likelihood of stable coronary artery disease(SCAD).Methods From March 2022 to August 2022,348 consecutive SCAD patients(146 males,202 females,age(58±10)years)who underwent exercise or pharmacological stress G-MPI(CZT SPECT)in Beijing Anzhen Hospital,Capital Medical University were retrospectively recruited.Left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),and left ventricular ejection fraction(LVEF)were acquired using quantitative gated SPECT(QGS)analysis.EDV and ESV were corrected by body surface area(BSA)to obtain EDV index(EDVI)and ESV index(ESVI),respectively.Independent-sample t test,one-way analysis of variance and Mann-Whitney U test were used for data analysis.The influences of EDV,ESV,EDVI,ESVI and LVEF were analyzed by multiple regressions for linear models.Results There were 314 patients with low-likelihood of SCAD(128 males,186 females,age(58±10)years)and 34 normal controls(18 males,16 females,age(55±10)years).There were no significant differences of basic clinical characteristics and left ventricular function parameters in different genders between 2 groups(z values:from-1.74 to-0.02,t values:from-1.16 to 1.17,all P>0.05).Using the 95%CI as the cut-off value for left ventricular function parameters in patients with a low-likelihood of SCAD,the upper limits of EDV,ESV,EDVI and ESVI in females and males were 84 and 111 ml,30 and 44 ml,47 and 54 ml/m^(2),17 and 21 ml/m^(2),respectively,and the lower limit of LVEF in females and males were 58%and 55%,respectively.In the low-likelihood of SCAD group,the EDV((58±13)vs(77±17)ml)and ESV((16±7)vs(26±9)ml)of females were smaller than those of males(t values:10.65,10.35,both P<0.001),while LVEF of females was higher than that of males((72±7)%vs(67±6)%;t=-6.23,P<0.001).However,there were no significant differences in left ventricular function parameters amon

关 键 词：冠心病 心肌灌注显像 心室功能 左 体层摄影术 发射型计算机 单光子 参考值 

分 类 号：R541.4[医药卫生—心血管疾病]