SPECT与MCE在STEMI术后冠脉微循环灌注的相关性研究  

Study on the correlation between single photon emission computed tomography and myocardial contrast echocardiography with coronary microcirculation perfusion after ST-segment elevated myocardial infarction surgery

作　　者：林玉萍 黄锦杭 张海林 李盛 卫展扬 苏少辉 LIN Yuping;HUANG Jinhang;ZHANG Hailin;LI Sheng;WEI Zhanyang;SU Shaohui(Department of Cardiology,the Tenth Affiliated Hospital of Southern Medical University/Dongguan People's Hospital,Dongguan 523000,China;Department of Ultrasound,the Tenth Affiliated Hospital of Southern Medical University/Dongguan People's Hospital,Dongguan 523000,China)

机构地区：[1]南方医科大学第十附属医院/东莞市人民医院心血管内科,广东东莞523000 [2]南方医科大学第十附属医院/东莞市人民医院超声科,广东东莞523000

出　　处：《长春中医药大学学报》2024年第4期442-445,共4页Journal of Changchun University of Chinese Medicine

基　　金：广东省基础与应用基础研究基金项目(2020B1515120003);东莞市社会科技发展(一般)项目(202050715001258)。

摘　　要：目的探究单光子发射计算机断层成像术(SPECT)与心肌声学造影(MCE)评估急性ST段抬高型心肌梗死(STEMI)介入术后冠脉微循环灌注的相关性研究。方法选择经皮冠状动脉介入术(PCI)术后的STEMI患者80例,采用随机数表法分为SPECT组和MCE组,各40例。SPECT组采用SPECT检测,MCE组采用MCE检测。比较2组心功能、影像学诊断效果、冠脉功能、不良心血管事件(MACE)以及出血事件发生率。结果术后,2组LVEF、LVESD、LVEDD、FFR、CFR均得到改善(P<0.05),但组间比较差异无统计学意义(P>0.05)。SPECT组真阳性率(TPR)、真阴性率(TNR)、阳性预测值、阴性预测值与MCE组TPR、TNR、阳性预测值、阴性预测值比较,差异均无统计学意义(P>0.05);SPECT组MACE发生率、出血事件发生率与MCE组比较,差异均无统计学意义(P>0.05)。结论SPECT与MCE影像学检查手段评估PCI术后STEMI患者的冠脉微循环灌注情况有很高的应用价值,可提高评估心功能准确度,减少有创操作身体损害。Objective To explore the correlation between single photon emission computed tomography(SPECT)and myocardial contrast echocardiography(MCE)in evaluating coronary microcirculation perfusion after acute ST-segment elevated myocardial infarction(STEMI)intervention.Methods Eighty patients with STEMI after percutaneous coronary intervention(PCI)were selected and divided into SPECT group(n=40)and MCE group(n=40)according to random number table method.The SPECT group was detected by SPECT,and the MCE group was detected by MCE.The cardiac function,imaging diagnosis effect,coronary function,major adverse cardiovascular events(MACE)and incidence of bleeding events were compared between two groups.Results After surgery,left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricuar end-diastolic diameter(LVEDD),fractional flow reserve(FFR)and coronary flow reserve(CFR)were improved in two groups(P<0.05),but there was no statistically significant difference between the groups(P>0.05).There were no statistically significant differences in true positive rate(TPR),true negative rate(TNR),positive predictive value,and negative predictive value between SPECT group and MCE group(P>0.05).There was no statistically significant diference in the incidence of MACE and bleeding events between SPECT group and MCE group(P>0.05).Conclusion SPECT and MCE have high application value in evaluating the coronary microcirculation perfusion in patients with STEMI after PCI,which can improve the accuracy of evaluating cardiac function and reduce the physical damage caused by invasive surgery.

关 键 词：冠心病 经皮冠状动脉介入术 急性ST段抬高型心肌梗死 单光子发射计算机断层成像术 声学造影 

分 类 号：R541.4[医药卫生—心血管疾病]