论文部分内容阅读
目的 为了证实多巴酚丁胺９９ｍＴｃＭＩＢＩ心肌断层显像诊断冠心病的价值，临床１０４ 例患者进入本试验。方法 多巴酚丁胺用生理盐水稀释后分级经静脉滴入，待达到预定最大剂量后，静脉推注９９ｍＴｃＭＩＢＩ７４０ＭＢｑ，维持多巴酚丁胺液２ 分钟，６０ 分钟后行心肌断层显像，隔日以同等条件再次行静态心肌断层显像。结果 ３６ 例非心肌梗塞阳性３４ 例，敏感性９４－４ ％ ，４８ 例心肌梗塞４５ 例阳性，敏感性９３－８％ 。单支，双支和三支病变的敏感性分别为８６－８％ ，９５－８ ％ 和１００％ 。检出ＲＣＡ，ＬＡＤ，ＬＣＸ 的敏感性与特异性分别为９１－７％ 和７５－８％ ，８６－８％ 和８１－６ ％ ，７０％ 和８１－６ ％ 。介入性治疗３ ～６ 个月内。多巴酚丁胺ＥＣＴ 的１１６ 个室壁节段异常中，心肌缺血消失和改善７９ 个节段，总有效率６８－１ ％ 。３２ 个节段心肌梗塞，术后４３－８ ％ 的室壁节段缺血消失或改善。８４ 个节段ＥＣＴ 呈心梗伴缺血或单纯缺血，术后７７－４ ％ 的异常室壁节段缺血得到改善。心肌有明显缺血者疗效明显高于心梗者（Ｐ＜０－０１）。结论 多巴酚丁胺ＥＣＴ 对诊断冠心病心肌缺血与潘生丁和运动ＥＣＴ一样有较高的灵敏性和特异?
Objective To confirm the value of dobutamine 99mTc-MIBI myocardial imaging in the diagnosis of coronary heart disease, clinical 104 patients entered the trial. Methods Dobutamine was diluted with saline and then graded by intravenous infusion. After the maximum dose was reached, 99mTcMIBI740MBq was injected intravenously to maintain the dobutamine solution for 2 minutes and 60 minutes later for myocardial perfusion imaging. On the same day, static myocardial tomography was performed again under the same conditions. Results 36 cases of non-myocardial infarction positive in 34 cases, the sensitivity of 94-4%, 48 cases of myocardial infarction in 45 cases, the sensitivity of 93-8%. The sensitivity of single, double and triple lesions were 86-8%, 95-8% and 100%, respectively. The sensitivities and specificities of detecting RCA, LAD and LCX were 91-7% and 75-8%, 86-8% and 81-6%, 70% and 81-6%, respectively. Interventional treatment within 3 to 6 months. Among the 116 wall segment abnormalities in dobutamine ECT, myocardial ischemia disappeared and 79 segments were improved, with a total effective rate of 68-1%. 32 segments of myocardial infarction, 43-8% of the wall segment after ischemia disappeared or improved. 84 segments of ECT were myocardial infarction with ischemia or simple ischemia, postoperative 77-4% of abnormal wall segment ischemia was improved. Myocardial ischemia was significantly higher than those with myocardial infarction (P <0-01). Conclusion Dobutamine ECT in diagnosis of myocardial ischemia with dipyridamole and exercise ECT have the same high sensitivity and specificity?