| 秦淑玲,高伯山,陈步星,梁铁军.99mTc-MIBI心肌断层显像多巴酚丁胺试验对冠心病诊断的临床价值[J].中国医学影像技术,2000,16(1):0045~47 |
| 99mTc-MIBI心肌断层显像多巴酚丁胺试验对冠心病诊断的临床价值 |
| The Clinical Value of Technetium-99m-Methoxyisobutyl Isonitrile Dobutamine Stress MyocardialTomography to Diagnose Coromary Heart Disease |
| 投稿时间：1999-09-20 |
| DOI： |
| 中文关键词: 多巴酚丁胺 心肌断层显像 冠心病 |
| 英文关键词:Dobutamine Stress myocardial tomography Coronary heart disease |
| 基金项目: |
|
| 摘要点击次数: 1429 |
| 全文下载次数: 58 |
| 中文摘要: |
| 目的 为了证实多巴酚丁胺99mTc-MIBI 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99m Tc-MIBI 740MBq ,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7714 %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2ECT 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性。 |
| 英文摘要: |
| Purpose This text is to determine the safty and clinical usefulness of diagnosing coronary heart disease by using dobutamine stress ECT. Methods Dobutamine diluted with physiological salt solution was administered intravenously by stepwise infusion. The technetium-99m-methoxyisobutyl isonitrile was given during the infusion of dobutamine
to a predicted maximum dose of 40ug/ kg/ min. And dobutamine infusion was terminated two minutes later. The method
was done again in the day after tomorrow. Results Thirty-four cases of 36 patients diagnosed as myocardial ischemia (nonmyocardial infarction) were detected by this technique (the sensitivity was 94. 4 %) . While fourty-five cases of 48 subjects
diagnosed as myocardial infarction were found in the test (the sensitivity was 93. 8 %) . Using this method , the sensitivity
of diagnosing one-vessel disease was 86. 8 %(33 of 38) , two-vessel disease 95. 8 % (23 of 24) ,and three-vessel disease
100 % (22 of 22) ,while the sensitivity and the specificity of detection of RCA ,LAD & LCX disease were 91. 7 % and
75.8 % ,86. 8 % and 81. 6 % ,70 % and 81. 6 % ,respectively. In addition ,the effect of interventional therapy for segmental
wall abnormalities of coronary heart disease can be monitered after the operation. The areas of myocardial ischemia were improved or even disappeared in seventy2nine of 116 abnormal wall segments. In details ,fourteen of ischemic segments were
disappeared or improved in 32 wall segments diagnosed as myocardial infarction by the stress tomographic imaging
(43.8 %) ,while 77. 4 % (64/ 84) segmental wall abnormalities only suffering ischemia were improved or disappeared. It
seems to be true that the diagnosis of myocardial ischemia is more sensitive than that of myocardial infarction by the method
( P < 0.01) . Conclusion Myocardial tomographic imaging combined with dobutamine infusion has significant sensitivity
and specifity for diagnosing coronary heart disease. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
