摘要
目的:探讨99mTc-甲氧基异丁基异腈(MIBI)门控心肌断层显像(G-MPI)在冠状动脉支架术后疗效评价、判断再狭窄以及预后评估的临床价值。方法:78例患者,冠状动脉支架术后3~12个月内均行G-MPI,其中31例有术前对照。33例复查冠状动脉造影(CAG)。随访13~24个月。结果:①31例复查G-MPI24例心肌灌注有改善,改善率为77.4%。②31例术后静息G-MPI所测左室射血分数(LVEF)较术前由(42.6±8.6)%上升至(49.7%±6.4)%,P<0.05;舒张末期容积(EDV)和收缩末期容积(ESV)分别由(158.2±55.3)ml、(92.6±44.9)ml明显下降到(133.9±39.9)ml、(71.2±28.7)ml,P均<0.01。③33例复查CAG患者,G-MPI对再狭窄诊断的敏感性、特异性、准确性为82.3%、85.0%、84.8%。④随访心脏事件发生率术后G-MPI灌注改善组(1.9%)与异常组(28.6%)之间有极显著差异(P<0.01)。结论:G-MPI对冠心病血运重建术后疗效评价、判断再狭窄以及预后评估具有重要的临床价值。
Objective:To assess the value of ^99mTc-methoxyisobutylisonitrile (MIBI) gated myocardial perfusion imaging (G-MPI) for evaluation of perfusion improvement, prediction of restenosis and cardiac event rate in patients undergoing successful stent implantation. Methods:Seventy-eight patients underwent G-MPI 3-12 months after operation. G-MPI was also performed in 31 patients before operation, and 33 patients underwent coronary angiography (CAG). The patieuts were followed up for 13-24 months. Results: ① Among 31 patients, perfusion imaging was improved in 24 cases, and the improved rate was 77.4%. ②LVEF was increased from(42.6 ± 8.6)% to (49.7% ± 6.4)%,P 〈 0.05; EDV and ESV were decreased significantly [(158.2 + 55.3) ml vs (133.9 ± 39.9) ml, and (92.6± 44.9) ml vs (71.2±28.7) ml, P 〈 0.01, respectively]. ③Restenosis was detected in 33 patients. Sensitivity,specificity and accuracy rates of G-MPI for predicting restenosis were 82.3%, 85.0%, 84.8%. ④During the follow-up, the incidence rate of cardiac events in non-ischemic group was significantly lower than that in abnormal group (1.9% vs 28.6%, χ^2 = 12.95,P 〈 0.01). Conclusion:G-MPI is an excellent tool to evaluate the effects of stent implantation and to predict restenosis, and cardiac events.
出处
《南京医科大学学报(自然科学版)》
CAS
CSCD
北大核心
2006年第9期761-763,768,共4页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省卫生厅2005年度医学科技发展基金资助(H200509)