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目的 评价三磷酸腺苷 (ATP)药物负荷99mTc MIBI心肌灌注断层显像在诊断冠心病中的可行性、安全性和特异性。方法 共 2 6 3例临床诊断为冠心病的病人。所有病人都行ATP负荷的99mTc MIBI心肌灌注显像 (0 16mg/kg/min ,5min)检查。在静脉注射ATP 3分钟时静脉注射 2 0mCi的99mTc MIBI,6 0分钟后行心肌断层显像。再于 4 8小时后静脉注射99mTc MIBI 2 0mCi,行静息心肌灌注断层显像。 5 1例病人在 2周内行冠状动脉造影以评价ATP介入心肌灌注断层显像诊断冠心病的准确性。在静脉注射ATP的过程中仔细地观察心脏的和非心脏的反应。结果 所有病人都完成整个ATP负荷试验。尽管有 5 8 9%的病人有不同类型的副作用发生 ,但其程度都不严重。无任何病人需要氨茶碱。最为严重的副作用是II度II型房室传导阻滞 (4/ 2 6 3) ,但其持续时间均短暂。ATP介入心肌灌注断层显像诊断冠心病的敏感性和特异性分别为 97 1%和 82 4 %。结论 对于不能完成运动试验的病人 ,ATP负荷心肌灌注断层显像是安全、可行的诊断冠心病的影像学技术。
Objective To evaluate the feasibility, safety and specificity of adenosine triphosphate (ATP) drug load 99mTc MIBI myocardial perfusion tomography in the diagnosis of coronary heart disease. Methods A total of 263 cases of patients with clinical diagnosis of coronary heart disease. All patients underwent ATP load 99mTc MIBI myocardial perfusion imaging (0 16mg / kg / min, 5min) examination. Intravenous ATP 3 minutes intravenous injection of 20mCi 99mTc MIBI, 60 minutes after myocardial imaging. Another 48 hours after intravenous injection of 99mTc MIBI 2 0mCi, resting myocardial perfusion tomography. Fifty-one patients underwent coronary angiography within 2 weeks to evaluate the accuracy of the interventional myocardial perfusion tomography in the diagnosis of coronary heart disease. Cardiac and noncardiac responses were carefully observed during intravenous injection of ATP. Results All patients completed the entire ATP load test. Although 58.9% of patients had different types of side effects, they were not severe. No need for any patient aminophylline. The most serious side effect is Class II degree II atrioventricular block (4/263), but its duration is short. The sensitivity and specificity of ATP-mediated myocardial perfusion tomography in the diagnosis of coronary heart disease were 97.1% and 82.4%, respectively. Conclusions ATP-loaded myocardial perfusion tomography is a safe and feasible imaging technique for the diagnosis of coronary heart disease in patients who can not complete the exercise test.