摘要
目的：评价ATP负荷MPI（ ATP-MPI）诊断冠心病的安全性及临床诊断效能。方法对83例[男61例，女22例，年龄43～68（55．4±6．7）岁]疑似冠心病的患者行静息MPI及CAG，先注射99Tcm-MIBI 296 MBq，90 min后行静息MPI；3 h后按患者体质量以0．16 mg·kg－1·min－1静脉注射ATP 5 min，注射到3 min时从另一静脉通道注射99 Tcm-MIBI 925 MBq，90 min后进行ATP-MPI，观察患者在ATP应用过程中的不良反应。所有患者显像后1周内做CAG检查，计算ATP-MPI诊断冠心病的效能。结果83例患者中CAG异常64例，其中1支血管病变38例、2支血管病变17例、3支血管病变9例，即共检出99支病变血管；ATP-MPI异常60例，共检出91支病变血管，其中LAD 38支、LCX 29支、RCA 24支。 ATP-MPI对冠心病患者的诊断灵敏度为85．9％（55／64），特异性为14／19，准确性为83-1％（69／83），阳性预测值为91．7％（55／60），阴性预测值为60．9％（14／23）。 ATP负荷试验不良反应发生率为84．3％（70／83），不良反应多表现为血压轻度下降、心悸、气短、头晕、面部潮红等，能自行缓解。结论 ATP-MPI无创、简便、安全，对冠心病的诊断具有较高的效能，可以作为常规检查方法。
Objective To assess the safety and clinical value of ATP-induced stress MPI （ ATP-MPI） in the diagnosis of coronary heart disease （CHD）. Methods A total of 83 patients （61 males, 22 fe-males, age：43-68（55.4±6.7） years） with suspected CHD were included. Rest MPI was performed 90 min post injection of 296 MBq 99 Tcm-MIBI. ATP was infused intravenously 3 h later at a rate of 0.16 mg·kg-1 · min-1 for 5 min. Then, a dose of 925 MBq 99 Tcm-MIBI was injected intravenously 3 min post ATP infusion. ATP-MPI was performed 90 min later. All patients underwent CAG within 1 week after MPI to evaluate the diagnostic efficiency of ATP-MPI. The adverse reaction was observed. Results Ninety-nine diseased ves-sels were identified by CAG in 64 patients：38 patients had one-vessel disease, 17 patients had two-vessel disease and 9 patients had three-vessel disease. ATP-MPI detected 91 diseased vessels （ 38 LAD, 29 LCX and 24 RCA） in 60 patients. In the diagnosis of CHD, ATP-MPI had a sensitivity of 85.9% （55/64）, a specificity of 14/19, an accuracy of 83.1% （69/83）, a positive predictive value of 91.7% （55/60） and a negative predictive value of 60.9% （14/23）. The adverse reaction incidence of ATP stress test was 84.3%（ 70/83） . The symptoms included mild hypotension, palpitations, shortness of breath, dizziness and facial flush, which all resolved spontaneously without any treatment. Conclusion ATP-MPI is a noninvasive, convenient and safe imaging modality for the diagnosis of CHD, and can be routinely used.
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2015年第6期434-437,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
