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目的:探讨门控核素心肌灌注显像(G-MPI)对冠状动脉(冠脉)支架再狭窄的诊断价值。方法:65例冠脉支架术后3个月以上的患者行两日法负荷/静息99Tcm-甲氧基异丁基异腈(MIBI)G-MPI,所有患者的G-MPI与冠脉造影(CAG)均在同期的1个月内完成,其中先做CAG检查的患者未进行再次血运重建术。以CAG为标准,分析G-MPI诊断冠脉支架再狭窄的价值。结果:65例患者的88支冠脉共置入105枚支架,随访CAG发现38.5%(25/65)的患者出现支架再狭窄,发生再狭窄的支架数为29.5%(31/105);根据典型症状诊断支架再狭窄的敏感性、特异性和准确性分别为64.0%、22.5%、38.5%;心电图运动平板试验(ETT)诊断支架再狭窄的敏感性、特异性、准确性分别为41.2%、71.9%、61.2%;G-MPI诊断支架再狭窄的敏感性、特异性、准确性分别为92.9%、86.7%、88.6%,其准确性明显优于ETT(χ2=14.173,P<0.001)和症状(χ2=42.781,P<0.001)。结论:G-MPI诊断冠脉支架术后再狭窄具有良好的价值。
Objective: To evaluate the diagnostic value of gated-core myocardial perfusion imaging (G-MPI) in coronary artery (coronary) stent restenosis. Methods: Sixty-five patients undergoing coronary stenting for more than 3 months underwent two-day loading / resting 99Tcm-MIBI G-MPI. All patients underwent G-MPI with coronary angiography (CAG ) Were completed within one month of the same period, of whom patients who underwent CAG first did not undergo revascularization. Using CAG as a standard, the value of G-MPI in the diagnosis of coronary stent restenosis was analyzed. Results: A total of 105 stents were placed in 65 coronary arteries in 65 patients. Follow-up CAG found that 38.5% (25/65) patients had stent restenosis. The number of stent restenosis was 29.5% (31/105) The sensitivity, specificity and accuracy of typical symptoms in diagnosing stent restenosis were 64.0%, 22.5% and 38.5% respectively. The sensitivity, specificity and accuracy of electrocardiogram treadmill test (ETT) in diagnosing stent restenosis were 41.2% , 71.9%, 61.2%. The sensitivity, specificity and accuracy of G-MPI in the diagnosis of stent restenosis were 92.9%, 86.7% and 88.6%, respectively. The accuracy of G-MPI was significantly better than ETT (χ2 = 14.173, And symptoms (χ2 = 42.781, P <0.001). Conclusion: G-MPI has good value in the diagnosis of restenosis after coronary stenting.