核素心肌灌注显像在心脏X综合征的临床意义  

Significance of radionuclide myocardial perfusion tomography in patients with cardiological syndrome X

作　　者：丁荣晶[1] 旅朝霞[2] 张欣[3] 周素敏[1] 

机构地区：[1]大连医科大学附属第四医院心内科,辽宁大连116001 [2]大连医科大学附属一院心内科,辽宁大连116001 [3]大连医科大学附属一院核医学科,辽宁大连116001

出　　处：《临床荟萃》2003年第21期1215-1217,共3页Clinical Focus

摘　　要：目的　通过核素心肌灌注显像 ,评价心脏X综合征患者心肌血流灌注的特点。方法　选取心脏X综合征患者 (A组 ) 2 0例 ,健康体检者 (B组 ) 15例作为观察对象。通过核素心肌灌注显像 ,用定性和半定量分析方法评价其心肌灌注情况。结果　A组心肌灌注显像异常占 90 % (18/2 0 ) ,B组 2 0 % (3/15 )出现血流灌注异常 ,两组之间差异有统计学意义 (χ2 =17.5 ,P <0 .0 0 1)。A组缺损分布的特点是呈不规则的、散在的放射性稀疏。其存在血流灌注异常的心肌节段共计 5 7个 ,其中 6 3.16 %为可逆性缺损 ,17.5 4 %为部分可逆性缺损 ,10 .5 3%为固定性缺损 ,8.77%为反向分布。在 5 7个灌注异常节段中 ,缺血评分为 1分、2分、3分者分别占 80 .70 %、19.2 9%和 10 .5 3%。 18例心肌灌注异常的患者中 ,83.33%为多壁心肌灌注异常 ,分布于 2～ 7个室壁。结论　X综合征患者心肌灌注异常多见 ,其异常的范围较广泛 ,呈不规则、散在的放射性稀疏和可逆性缺损 ,但心肌缺血的程度轻 。Objective To evaluate the feature of abnormality of myocardial perfusion in cardiological syndrome X by 99 Tcm MIBI myocardial scintigrams.Methods Twenty patients with cardiological syndrome X (group A) and fifteen healthy volunteers as control (group B) were involved in the study. 99 Tc m MIBI myocardial scintigrams were performed in all the patients.Qualitative and semi quantitative methods were used to evaluate the characteristics of myocardial perfusion in the patients with cardiological syndrome X.Results Among 20 cases (180 segments) in group A,90% patients (18/20) showed abnormal myocardial perfusion tomography(MPT) with mild and non segmental perfusion defects distribution,which was 20% in group B(3/15).There was significant diference between them( P < 0.001 ).The abnormalities of MPT amount to 57 segments.Most focuses of MPT were reversible defects (RD)( 63.16% ).A few of them accompanied by part reversible defects,fixed reversible defects and reverse reversible defects (RRD) ( 17.54% , 10.53% and 8.77% ).Among the 57 abnormalities of MPT,perfusion defect score 1,score 2,score 3 was 80.70% , 19.29% and 10.53% ,respectively. 83.33% of myocardial perfusion abnormalities in 18 patients were multiple segments (2 7).Among 15 cases (135 segments) in group B,3% patients (2/15) showed abnormal myocardial perfusion tomography(MPT).Conclusion The characteristic of MPT abnormalities in cardiological syndrome X was broad,irregular,scattered and reversible defects.But heart function almost was not affected.

关 键 词：心脏X综合征 放射性核素显像 心肌灌注 临床诊断 

分 类 号：R817.4[医药卫生—影像医学与核医学] R541[医药卫生—放射医学]