运动^(201)Tl肺/心比值对高血压合并冠状动脉疾病的临床价值  

Clinical value of ~ ( 201)Tl lung/heart ratio during exercise in hypertensive patients with coronary artery disease

作　　者：欧阳伟[1] 何国荣[1] 刘金华[1] 黄玉英[1] 

机构地区：[1]第一军医大学附属珠江医院核医学科,广州510282

出　　处：《中华核医学杂志》2002年第5期302-304,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的　评价运动2 0 1Tl肺 /心比值对高血压合并冠状动脉疾病 (CAD)患者冠状动脉病变严重程度的诊断价值及其与左室舒张功能的相关性。方法　 1 9例正常对照者。 1 0 2例经冠状动脉造影确诊的CAD患者 ,分为 3组 :无高血压、高血压无心肌肥厚和高血压心肌肥厚组。受检者均行运动 延迟心肌灌注断层显像 ,取运动断层显像上的前位显像计算肺 /心比值。结果　无高血压组 ( 0 .4 3±0 .0 9,t=3.0 1 )、高血压无心肌肥厚组 ( 0 .4 2± 0 .1 2 ,t=2 .1 0 )和高血压心肌肥厚组 ( 0 .4 7± 0 .0 9,t =4 76 )的肺 /心比值均较对照组 ( 0 .36± 0 .0 5,P <0 .0 5～ 0 .0 1 )显著为高 ,但 3组间相比差异均无显著性 (P均 >0 .0 5) ;上述 3组单支和多支病变的肺 /心比值分别为 0 .4 0± 0 .0 9和 0 .4 6± 0 .1 0、0 .38± 0 .1 1和0 .4 8± 0 .1 2及 0 .4 6± 0 .1 1和 0 .4 8± 0 .1 0。前 2组单支与多支相比差异均有显著性 (P均 <0 .0 5) ,后组差异无显著性 (P >0 .0 5) ;3组患者肺 /心比值≥ 0 .4 5时对多支病变的诊断灵敏度和特异性分别为 82 %和 75%、90 %和 75%及 4 0 %和 4 5%。无高血压组 (r=0 .4 0 2 ,P <0 .0 1 )和高血压无心肌肥厚组 (r=0 .4 0 8,P <0 .0 5)的肺 /心比值与半定量评分均呈显著正相关 。Objective The purpose of the study was to evaluate the relationship between ~ 201Tl lung/heart ratio during exercise and left ventricular diastolic function and its diagnostic value on severity of coronary artery disease. Methods One hundred and two patients with documented coronary artery disease were divided into three groups, including no hypertension, hypertension without or with left ventricular hypertrophy groups. Exercise/delay ~ 201Tl myocardial perfusion tomography was performed on all patients included. Lung/heart ratio was defined on the anterior planar image obtained during exercise tomography. Results The lung/heart ratios during exercise in no hypertension(0.43±0.09, P<0.01), hypertension without(0.42±0.12, P<0.05)and with hypertrophy(0.47±0.09,P<0.01)groups all were significantly higher than that in control group(0.36±0.05), and there was no significant difference among three study groups(P>0.05). The lung/heart ratios of multi-vessel disease subgroup in no hypertension (0.46±0.10 vs 0.40±0.09,P<0.05 ) and hypertension without hypertrophy(0 48±0.12 vs 0.38±0.11,P<0.05) groups were significantly higher than that of single-vessel disease subgroups in the same groups, but no significant difference was found between single- and multi-vessel disease subgroups in hypertension with hypertrophy group(0.48±0.10 vs 0.46±0.11,P>0.05). When lung/heart ratio was≥0.45, the sensitivities for predicting the presence of multi-vessel disease were 82%, 90%, 40%, and specificities were 75%, 75%,45%,respectively, in no hypertension, hypertension without and with hypertrophy groups. In no hypertension(r=0.402,P<0.01) and hypertension without hypertrophy groups(r=0.408,P<0 05), lung/heart ratios showed a significant correlation with the semiquantitative score of myocardial fragment uptake, but did not show in hypertension with hypertrophy group(r=0.114,P>0.05). In no hypertension(r=-0.413,P<0.01), hypertension without(r=-0.662,P<0.01) and with hypertrophy groups(r=-0.408,P<0.05), lung/heart rati

关 键 词：高血压 冠状动脉疾病 铊放射性同位素 

分 类 号：R817[医药卫生—影像医学与核医学]