99mTC-MIBI门控负荷心肌灌注显像对尿毒症患者MACE的预测价值分析  

Predictive Value of 99mTC-MIBI Gated Stress Myocardial Perfusion Imaging on MACE in Patients with Uremia

作　　者：陈正福 张学敏 CHEN Zheng-fu;ZHANG Xue-min(Department of Nuclear Medicine,321 Hospital,Hanzhong 723000,Shaanxi Province,China)

机构地区：[1]三二〇一医院核医学科,陕西汉中723000

出　　处：《中国CT和MRI杂志》2023年第7期66-68,共3页Chinese Journal of CT and MRI

摘　　要：目的观察尿毒症患者99mTc标记的甲氧基异丁基异腈(MIBI)门控心肌灌注显像(GMPI)的特点,分析各参数对主要不良心血管事件(MACE)的预测价值。方法选取2017年4月至2021年4月我院79例尿毒症患者临床资料为样本进行回顾性分析,采集两组临床资料,并根据随访期间(6个月)MACE发生情况将患者分为MACE组(26例)和非MACE组(53例),所有研究对象均进行99mTc-MIBI GMPI检测并计算左室舒张末期体积(LVEDV)、左室收缩末期体积(LVESV)、左心室射血分数(LVEF)、高峰射血率(PER)及高峰充盈率(PFR)、负荷总评分(SSS)、总静息评分(SRS)、运动-静息总评分差(SDS)、相位标准差(PSD)、相位直方图带宽(PBW)和熵等参数,比较两组基线资料和99mTc-MIBI GMPI参数并分析其对MACE的预测价值。结果MACE组年龄明显高于非MACE组(P<0.05),入院时维持性血液透析(MHD)治疗患者占比明显低于非MACE组(P<0.05),两组性别、病程和原发疾病等基线资料差异无统计学意义(P>0.05);MACE组PER低于非MACE组,SDS、PSD、PBW和熵高于非MACE组,差异有统计学意义(P<0.05);PER、SDS、PSD、PBW和熵预测尿毒症患者MACE的AUC分别为0.692、0.696、0.669、0.713和0.731,联合各项指标建立回归模型进行预测的AUC为0.909,敏感度和特异度分别为76.92%和95.57%。结论尿毒症患者心脏结构及心脏功能均可发生异常,99mTc-MIBI GMPI检测有利于及时发现心肌血流灌注和代谢异常情况,对预测MACE发生具有良好参考价值。Objective To observe the characteristics of 99mTc-labeledmethoxyisobutylisonitrile(MIBI)gated myocardial perfusion imaging(GMPI)in patients with uremia,and to analyze the predictive value of parameters on major adverse cardiovascular events(MACE).Methods Clinical data of 79 patients with uremia in the hospital between April 2017 and April 2021 were selected as samples for retrospective analysis.The clinical data of the two groups were collected,and the patients were divided into MACE group(26 cases)and non-MACE group(53 cases)by means of occurrence of MACE during follow-up(6 months).All the subjects underwent 99mTc-MIBI GMPI detection,and the parameters such as left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),peak ejection rate(PER)and peak filling rate(PFR),summed stress score(SSS),summed rest score(SRS),summed difference score(SDS),phase standard deviation(PSD),phase histogram bandwidth(PBW)and entropy were calculated.The 99mTc-MIBI GMPI parameters of each group were compared and their predictive value on MACE was analyzed.Results The age of MACE group was significantly older than that of non-MACE group(P<0.05),and the proportion of patients undergoing maintenance hemodialysis(MHD)at admission was significantly lower than that of non-MACE group(P<0.05),but there were no statistical differences in baseline data such as gender,course of disease and primary disease between the two groups(P>0.05).The PER in MACE group was lower while the SDS,PSD,PBW and entropy were higher compared to non-MACE group(P<0.05).The AUCs of PER,SDS,PSD,PBW and entropy on predicting MACE in patients with uremia were 0.692,0.696,0.669,0.713 and 0.731 respectively.The AUC,sensitivity and specificity of established regression model by combining various indicators for prediction were 0.909,76.92%and 95.57%respectively.Conclusion Abnormal cardiac structure and abnormal cardiac function may occur in patients with uremia.The detection of 99mTc-MIBI GMPI is conduciv

关 键 词：尿毒症 门控心肌灌注显像 维持性血液透析 主要不良心血管事件 

分 类 号：R692.5[医药卫生—泌尿科学]