目的　本研究旨在评估运动 静息心肌灌注显像对冠状动脉腔内成形术 (PTCA)后患者预后的预测价值。方法　对 16 0例PTCA术后行99mTc 甲氧异丁基异腈 (MIBI)运动 静息心肌灌注显像的患者 ,随访 (36± 2 8)个月。结果　随访期间 ,34例 (2 1.3% )患者发生心脏事件 ,其中心肌显像提示的心肌缺血组 (n =4 3)心脏事件发生率为 6 2 .8% ,明显高于心肌梗死组 (n =32 ,12 .5 % ,χ2 =19.3,P <0 .0 0 0 1) ,而且也明显高于心肌显像正常组(n =85 ,3.5 % ,χ2 =5 7.4 4 ,P <0 .0 0 0 1)。心肌缺血组的无心脏事件生存率在 1年 ,3年 ,5年和 10年分别为 5 6 % ,32 % ,2 6 %和 2 6 % ,而正常组在相同时间内的无心脏事件生存率为 99% ,97% ,94 %和 94 %。多元线性分析显示 ,可逆性心肌灌注缺损节段是预测PTCA术后发生心脏事件的最重要的独立危险因子 (RR =5 .13,P <0 .0 0 0 1)。结论　99mTc MIBI运动 静息心肌灌注显像对PTCA术后患者的预后有重要的预测价值 Objectives This study was designed to evaluate the predictive value of resting myocardial perfusion imaging after exercise in patients with coronary artery disease after coronary angioplasty (PTCA). Methods One hundred and sixty patients (99 ± 20) who underwent 99mTc methoxycinnamic acid (MIBI) resting myocardial perfusion imaging after PTCA were followed up for 36 ± 28 months. Results During follow-up, cardiac events occurred in 34 patients (21.3%). The incidence of cardiac events in myocardial ischemia group (n = 4 3) was 62.8%, which was significantly higher than that in myocardial infarction group (n = 32, 12.5%, χ2 = 19.3, P <0.0001), but also significantly higher than those in normal myocardial imaging group (n = 85, 3.5%, χ2 = 5 7.44, P <0 .0 0 0 1). The rate of no cardiac events in myocardial ischemia group was 56%, 32%, 26% and 26% at 1 year, 3 years, 5 years and 10 years respectively, but no cardiac events in normal group at the same time Survival rates were 99%, 97%, 94%, and 94%. Multivariate linear analysis showed that reversible myocardial perfusion defect segments were the most important independent risk factors for predicting cardiac events after PTCA (RR = 5.13, P <0.0001). Conclusion 99mTc MIBI resting myocardial perfusion imaging has important predictive value for the prognosis of PTCA patients