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目的:探讨腺苷负荷心肌灌注显像对冠状动脉(冠脉)介入治疗的临床意义。方法:66例冠心病患者,行腺苷负荷心肌灌注显像和冠脉造影,根据需要进行介入治疗,介入治疗后3～7天复查腺苷负荷心肌灌注显像。腺苷负荷心肌灌注显像采用单光子发射断层显像图像采集系统,腺苷注射液总量为840μg/kg,6分钟匀速静脉泵入,腺苷泵入3分钟时静脉推注99锝-2-甲氧基异丁基异腈核素(99mTc-MIBI);1.5h后进行心肌灌注断层显像。若异常,次日行静息心肌显像。核素显像左心室心肌分为9个节段,心肌灌注评分分4级。结果:66例患者的腺苷负荷心肌灌注显像与冠脉造影结果相比,双支病变腺苷负荷心肌灌注显像阳性率(87.5%,28/32)和三支病变腺苷负荷心肌灌注显像阳性率(100%),与冠脉造影阳性率(100%)比较差异均无统计学意义(P>0.05);单支病变腺苷负荷心肌灌注显像阳性率为54.5%(12/22),与冠脉造影阳性率(100%)比较差异有统计学意义(P<0.01)。双支病变和三支病变腺苷负荷心肌灌注显像阳性率分别与单支病变相比,差异均有统计学意义(P均<0.05)。冠脉介入后心肌核素显像血流灌注改善率为94.1%(32/34),与冠状动脉介入前(0%,0/34)自身对照,差异有统计学意义(P=0.003)。结论:腺苷负荷心肌灌注显像对于冠心病患者冠脉介入前病变程度分析以及介入后疗效判断有一定的临床意义。
Objective: To investigate the clinical significance of adenosine stress myocardial perfusion imaging in coronary artery (coronary artery) interventional therapy. Methods: Sixty-six patients with coronary heart disease underwent adenosine stress myocardial perfusion imaging and coronary angiography. Interventional therapy was performed according to need. Adenosine load myocardial perfusion imaging was performed 3 to 7 days after interventional therapy. Adenosine stress myocardial perfusion imaging using single photon emission tomography image acquisition system, the total adenosine injection of 840μg / kg, 6 minutes of constant venous pumping, adenosine pumpin 3 minutes intravenous injection of 99 technetium-2 - methoxy isobutyl isonitrile (99mTc-MIBI); 1.5h myocardial perfusion imaging. If abnormal, resting myocardial imaging next day. Radionuclide imaging of left ventricular myocardium is divided into 9 segments, myocardial perfusion score of 4. Results: Compared with coronary angiography, adenosine stress myocardial perfusion imaging in 66 patients showed that the positive rate of adenosine stress myocardial perfusion imaging was 87.5% (28/32) in double-vessel disease and adenosine stress myocardial perfusion The imaging positive rate (100%) was not significantly different from that of coronary angiography (100%) (P> 0.05). The positive rate of adenosine stress myocardial perfusion imaging was 54.5% (12 / 22), and the positive rate of coronary angiography (100%) was significantly different (P <0.01). The positive rates of double-vessel disease and adenosine stress myocardial perfusion imaging were significantly different from those of single vessel disease (P <0.05). The improvement rate of perfusion of myocardial radionuclide after coronary intervention was 94.1% (32/34), which was significantly different from that before coronary intervention (0%, 0/34) (P = 0.003). Conclusions: Adenosine stress myocardial perfusion imaging in patients with coronary heart disease before coronary angiography and analysis of the efficacy of intervention has some clinical significance.