^(99m)Tc-MIBI门控心肌灌注显像对行沙库巴曲缬沙坦治疗的冠心病患者心肌血流灌注及心功能的评估价值  

Evaluation value of ^(99m)Tc MIBI GMPI on myocardial blood flow perfusion and cardiac function in patients with coronary heart disease undergoing sacubarta valsartan treatment

作　　者：郝亚逢[1] 张利峰 王学智[1] 李远[3] 苗睿 王献忠[1] 武国霞 HAO Yafeng;ZHANG Lifeng;WANG Xuezhi;LI Yuan;MIAO Rui;WANG Xianzhong;WU Guoxia(Department of Cardiology,Handan First Hospital,Handan 056000,China)

机构地区：[1]邯郸市第一医院心内二科,河北邯郸056000 [2]河北工程大学附属医院心内一科,河北邯郸056008 [3]石家庄市第四医院急诊科,河北石家庄050035 [4]邯郸市涉县医院老年医学科,河北邯郸056499

出　　处：《陕西医学杂志》2024年第4期514-517,522,共5页Shaanxi Medical Journal

基　　金：河北省卫生健康委员会重点科技研究计划项目(20200426);河北省邯郸市科学技术研究与发展计划项目(1823208085ZC)。

摘　　要：目的:探究^(99m)Tc-MIBI门控心肌灌注显像(GMPI)评估冠心病患者沙库巴曲缬沙坦治疗后心肌血流灌注及心功能的价值。方法:选取冠心病患者78例,入组患者均接受沙库巴曲缬沙坦治疗,采用^(99m)Tc-MIBI GMPI对患者的心肌血流灌注情况及心功能指标进行检测,并以超声心动图及冠状动脉造影结果为参照,对^(99m)Tc-MIBI GMPI检查的准确性进行探究。结果:患者经冠状动脉造影检查结果与患者经^(99m)Tc-MIBI GMPI检查心肌血流灌注结果比较无统计学差异(P>0.05),经卡帕一致性检验,KAPPA值为0.826,一致性较好。患者经冠状动脉造影检查结果与患者经^(99m)Tc-MIBI GMPI心功能结果[舒张末期容积(EDV)、收缩末期容积(ESV)、左心室射血分数(LVEF)、心输出量(CO)]比较无统计学差异(均P>0.05),经ICC一致性检验,ICC=0.812,一致性较好。治疗后与治疗前比较,患者的心肌血流灌注有所好转,患者完全闭塞、重度狭窄占比降低,轻度狭窄占比升高(均P<0.05)。与治疗前比较,治疗后患者的EDV、ESV水平降低,LVEF、CO升高(均P<0.05)。78例患者经过治疗,出现8例症状性低血压,2例轻度血管性水肿,6例肾功能损伤,3例高钾血症,并发症发生率约为24.36%。结论:^(99m)Tc-MIBI GMPI评估心肌血流灌注及心功能情况与超声心动图及冠状动脉造影结果相一致,可以准确地反映冠心病患者经沙库巴曲缬沙坦治疗后的心肌血流灌注及心功能变化。经沙库巴曲缬沙坦治疗,患者的心肌血流灌注及心功能得到改善,但需要对患者的不良反应情况进行关注。Objective:To investigate the value of ^(99m)Tc-MIBI gated myocardial perfusion imaging(GMPI)in evaluating myocardial blood flow perfusion and cardiac function in patients with coronary heart disease after treatment with sacubactril and valsartan.Methods:Seventy-eight patients with coronary heart disease were selected,and all the enrolled patients received sacubatrotril and valsartan treatment.The myocardial blood perfusion and cardiac function indexes of the patients were detected using ^(99m)Tc-MIBI GMPI,and the results of echocardiography and coronary angiography were used as reference.The accuracy of ^(99m)Tc-MIBI GMPI test was investigated.Results:There was no difference between the results of coronary angiography and those of ^(99m)Tc-MIBI GMPI(P>0.05),after kappa consistency test,kappa value was 0.826,indicating good consistency.There was no difference between the coronary angiography and ^(99m)Tc-MIBI GMPI cardiac function results(EDV,ESV,LVEF,CO)(all P>0.05).After ICC consistency test,ICC was 0.812,with good consistency.After treatment,compared with before treatment,the myocardial blood perfusion of patients improved,the proportion of patients with complete occlusion and severe stenosis decreased,and the proportion of patients with mild stenosis increased(all P<0.05).Compared with before treatment,the EDV and ESV levels of patients after treatment were decreased,while LVEF and CO were increased(all P<0.05).Of the 78 patients treated,8 had symptomatic hypotension,2 had mild angioedema,6 had renal injury,and 3 had hyperkalemia.The complication rate was 24.36%.Conclusion:The ^(99m)Tc-MIBI GMPI assessment can accurately reflect the myocardial blood perfusion and cardiac function changes in patients with coronary heart disease after treatment with sacubatrotril and valsartan,which is consistent with the results of echocardiography and coronary angiography.After treatment with sacubatrotril and valsartan,the myocardial blood perfusion and cardiac function of the patients were significantly improved,but the adve

关 键 词：^(99m)Tc-MIBI门控心肌灌注显像 冠心病 沙库巴曲缬沙坦 心肌血流灌注 心功能 

分 类 号：R543.3[医药卫生—心血管疾病]