摘要
目的采用99mTc-甲氧基异丁基异腈(MIBI)/18F-脱氧葡萄糖(FDG)双核素SPECT心肌显像与平板运动试验对陈旧性心肌梗死患者存活心肌检测进行比较,探讨平板运动试验评价陈旧性心肌梗死患者存活心肌的可行性及临床价值。方法选择确诊的陈旧性心肌梗死患者45例,所有患者均行99mTc-MIBI/18F-FDG双核素SPECT及平板运动试验检查。根据99mTc-MIBI/18F-FDG双核素SPECT显像结果判定存活心肌,将患者分为2组,即心肌存活组与心肌无存活组。比较平板运动试验各项指标在两组间的变化,分别计算其识别存活心肌的敏感性、特异性和准确性。结果 45例患者中24例为心肌存活组(n=24),21例为心肌无存活组(n=21);心肌存活组中87.5%(21/24)Q波延长,75.0%(18/24)QT离散度≤70ms;Q波延长判断心肌存活的敏感性、特异性和准确性分别是87.5%、85.7%和86.7%,QT离散度≤70ms判断心肌存活的敏感性、特异性和准确性分别是75.0%、71.4%和60.0%。结论在陈旧性Q波型心肌梗死单支病变患者中,平板运动试验指标Q波延长和QT离散度检测存活心肌具有较高的敏感性和特异性。
Objective To investigate the correlation between myocardial viability in old myocardial infarction as assessed by treadmill exercise test and 99mTc-MIBI/18F-FDG dual isotope simultaneous acquisition of single photon emission computed tomography （SPECT）. Methods 45 consecutive patients with old myocardial infarction underwent coronary arteriography, treadmill exercise testing and 99mTc-MIBI/18F-FDG dual isotope simultaneous acquisition of SPECT. Patients were classified into myocardial viability group and non myocardial viability group according to 99mTc-MIBI/18F-FDG SPECT. The indices of treadmill exercise testing were measured and compared in two groups. Compared with the results of 99mTc-MIBI/18F-FDG SPECT, the sensitivity, specificity, and accuracy of these indices for detecting myocardial viability were calculated. Results 24 out of the 45 studied patients were defined as myocardial viability group, and the rest of 21 patients were in non myocardial viability group. 87.5%（21/24） patients in myocardial viability group were accompanied with exercise-induced Q-wave prolongation. Myocardial viability was detected more often in patients （75.0%） with smaller QT dispersion （≤70ms）. The sensitivities and specificities of Q-wave prolongation and QT dispersion ≤ 70ms for evaluating myocardial viability were 87.5%, 85.7%, and 75.0%, 71.4%, respectively. Conclusion In patients with old myocardial infarction, exercise-induced Q-wave prolongation and QT dispersion were found to be the sensitive and specific ECG markers for detecting of myocardial viability.
出处
《云南医药》
CAS
2011年第1期2-5,共4页
Medicine and Pharmacy of Yunnan
关键词
存活心肌
平板运动试验
心肌梗死
Myocardial viability
Exercise electrocardiography
Myocardial infarction
