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目的 通过分析99mTc sestamibi核素运动心肌灌注断层显像 (SPECT)评价冠心病患者冠状动脉PTCA疗效。方法 4 5例冠心病患者 ,PTCA术后 1～ 2 4个月 ,静脉注射放射性示踪剂99mTc sestamibi,定性观察运动和静态心肌血流灌注情况 ,并行冠状动脉造影 ,利用 χ2 检验等评价冠心病患者单纯PTCA术与PTCA结合stent支架介入治疗疗效和运动心肌显像判断冠状动脉再狭窄情况。结果 ①PTCA术后 (包括Stent支架介入治疗 ) ,约 2 6 7%的患者出现术后再狭窄 ,并且再狭窄高峰时间发生在术后 2～ 3个月之内 ;②单纯PTCA术后冠脉血管再狭窄占狭窄总数 83 3% ,PTCA结合Stent支架介入治疗后血管再狭窄约占狭窄总数 16 7% ,两种方法有显著性差异 (P <0 .0 5 ) ;③以冠状动脉造影为参照 ,99mTc sestamibi运动心肌断层显像判断术后冠脉再狭窄灵敏性和特异性分别为 76 9%和 95 0 %。结论 99mTc sestamibi运动心肌灌注断层显像可用于评价PTCA或 /和stent介入治疗。
Objective To evaluate the efficacy of coronary artery PTCA in patients with coronary heart disease by analyzing 99mTc sestamibi radionuclide myocardial perfusion imaging (SPECT). Methods Twenty-five patients with coronary heart disease were enrolled. One month and two months after PTCA, radioactive tracer 99mTc sestamibi was intravenously injected. The perfusion of exercise and static myocardium was qualitatively evaluated. Coronary angiography was performed in parallel. Coronary heart disease Patients with simple PTCA combined PTCA with stent stenting and myocardial imaging to determine coronary artery stenosis. Results ① After PTCA (including Stent stenting), about 26.7% of the patients showed postoperative restenosis, and the peak time of restenosis occurred within 2 to 3 months after operation. ② After PTCA alone, Restenosis accounted for 83.3% of the total number of stenosis, restenosis after PTCA combined Stent stent treatment accounted for about 16.7% of the total number of stenosis, two methods were significantly different (P <0. 05); ③ coronary angiography as a reference The sensitivity and specificity of 99mTc sestamibi motor myocardial tomography in determining postoperative coronary artery restenosis were 76.9% and 95.0%, respectively. Conclusion 99mTc sestamibi exercise myocardial perfusion tomography can be used to evaluate the PTCA or / and stent intervention.