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目的:探讨门控心肌灌注显像(GMPI)相位分析预测冠状动脉粥样硬化性心脏病(简称冠心病)主要心脏不良事件(MACE)的价值。方法:回顾性分析自2012年9月至2014年1月于北京医院核医学科行两日法静息－负荷GMPI的627例受检者，收集一般临床资料、GMPI影像及相关参数[相位标准差(PSD)、相位直方图带宽(PBW)、熵、左心室射血分数(LVEF)、总负荷积分(SSS)、高峰射血率(PER)、高峰充盈率(PFR)]分析结果。随访至出现MACE(即心源性死亡、非致死性心肌梗死、GMPI检查后60 d内行晚期血运重建术)。组间比较采用n χ2检验、两独立样本n t检验或Wilcoxon秩和检验；应用多因素Cox比例风险回归模型分析MACE的独立危险因素，用Kaplan－Meier生存曲线分析累积无MACE生存率。n 结果:纳入成功完成随访的受检者共505例，其中男235例，女270例，中位年龄73岁。中位随访时间为55.6(52.0，60.5)个月，发生MACE者54例(10.7%)，其中心源性死亡6例、非致死性心肌梗死27例、晚期冠脉血运重建术21例。MACE组的高血压和高脂血症发生率高于无MACE组(n χ2值：4.126、6.021，均n P58 J·moln －1·Kn －1)及SSS ≥12分为MACE的独立危险因素[比值比(n OR)值分别为2.795(95% n CI：1.259～6.201)、3.213(95% n CI：1.468～7.029)、3.640(95% n CI：1.999～6.628)，均n P26.7°)组、PBW异常组、熵异常组的5年累积无MACE生存率分别为51.2%、63.2%和46.7%，明显低于PSD正常组(92.3%)、PBW正常组(94.2%)和熵正常组(92.8%),n χ2值分别为77.768、77.741、117.437，均n P58 J·moln -1·Kn -1) and SSS≥12 were independent risk factors for MACE (odds ratio(n OR) values: 2.795(95% n CI: 1.259-6.201), 3.213(95% n CI: 1.468-7.029), 3.640 (95% n CI: 1.999-6.628), all n P26.7°), abnormal PBW group and abnormal entropy group were 51.2%, 63.2% and 46.7%, which were significantly lower than those of normal PSD group (92.3%;n χ2=77.768, n P<0.05), normal PBW group (94.2%;n χ2=77.741, n P<0.05) and normal entropy group (92.8%;n χ2=117.437, n P<0.05). The 5-year cumulative MACE-free survival rate (31.7%) of patients with abnormal PBW and SSS≥12 was significantly lower than that of patients with normal PBW or patients with abnormal PBW and SSS<12 (80.1%-94.4%;n χ2=185.4, n P<0.01). The combination analysis of entropy and SSS showed similar results.n Conclusions:PBW and entropy obtained by GMPI phase analysis are independent risk factors for predicting MACE in coronary artery disease. GMPI phase analysis is useful for coronary artery disease risk stratification.