冠状动脉慢血流患者的腺苷负荷心肌灌注显像研究.pdf

698·JClinCardiol(China),Sep2009,Vo125,No9冠状动脉慢血流患者的腺苷负荷心肌灌注显像研究何疆春杨晔方庭正川玲朱智明费宇行[摘要]目的:评价腺苷负荷心肌灌注单光子发射计算机断层扫描(SPECT)在诊断冠状动脉慢血流(CSF)中的f临床价值。方法:根据冠状动脉造影(CAG)结果不同,分为CSF组、正常血流(NCF)组和CAG阳性组。使用校正的TIMI血流分级方法评价冠状动脉血流速度。3组均行CAG、静息心电图(ECG)、腺苷负荷ECG、静息及腺苷负荷SPECT检查,评价其心肌血流灌注情况。结果:CSF组腺苷负荷SPECT诊断心肌缺血阳性率(84%),明显高于平静ECG(20)及腺苷负荷ECG(52)。CSF组在腺苷负荷SPECT中显示心肌缺血的范围和程度高于NCF组,低于CAG阳性组。结论:CSF与心肌缺血关系密切,腺苷负荷SPECT可以作为检测CSF者心肌缺血的一种有效的无创性检查方法。[关键词]冠状动脉疾病;冠状动脉慢血流;腺苷;心肌灌注显像;心电描记术[中图分类号][文献标志码]A[文章编号]1001—1439(2009)09—0698—04AdenosinestressmyocardialperfusiontomographicimaginginpatientswithcoronaryslowflowHEjiangchunYANGYeFANGTingzhengCHUANGLingZHUZhimingFEIYuxing(DepartmentofCardiology,。DepartmentofNuclearMedicine,NavyGeneralHospitalofChi—nesePIA,Beiing,100037,China)Abstract0bjective:cMIBImyocardialperfusionSPECTincoronaryslowflow(CSF):ordingtotheireoro—naryangiographyresults,includingtheCSFgroup,normalcoronaryflow(NCF)groupandcoronaryarterysteno—(TIMI)framecount(CTFC),restingelectrocardiograph(ECG),adenosinestressECG,restanda—:ThepositiverateofCSFinadenosinestressmyocardialperfusionSPECTwassignificantlyhigherthanonadenosinestressECGandrestECG(P<).Thescopeanddegreeofmyocardialischemiaonadenosinemyocardialperfusio