多巴酚丁胺负荷试验^(99m)Tc-MIBI心肌断层显像诊断冠心病的应用

The evaluation of dobutamine^(99m)Tc-MIBI myocardial perfusion imaging in the diagnosis of coronary heart disease

为探讨多巴酚丁胺药物负荷试验替代运动试验进行核素心肌断层显像的临床价值,40例患者通过微量输液泵静脉给予多巴酚丁胺,逐渐加量,至高峰时注射(99m)~Tc-甲氧基异丁基异腈,之后行心肌图像采集,48小时再行静息态心肌显像。31例冠心病患者中30例多巴酚丁胺负荷试验阳性,9例非冠心病患者中2例阳性。其特异性为77.8%,灵敏度为96.8%。无1例因多巴酚丁胺副作用而停止试验。因此,多巴酚丁胺试验核素心肌灌注显像为一种安全而灵敏诊断冠心病的方法。

PURPOSE The method and the clinical value of dobutamine stress test as a substitute for exercise test in ^(99m)Tc- MIBI myocardial perfusion imaging were investigated.METHODS 40 patients were intravenously infused with dobutamine through IVAC syringe pumps by incremental doses,and ^(99m)Tc-MIBI was injected at the peak dobutamine heart rate.The myocar- dial imaging was then performed.The rest myocardial imaging was done after 48 hours.RESULTS 30 of the 31 patients with coronary heart disease showed reversible perfusion defects in dobutamine ^(99m)Tc-MIBI myocardial perfusion images and 7 of the 9 patients without coronary heart disease showed normal images.The sensitivity of this test was 96.8 % and the specificity 77.8%. None of the studies was discontinued due to dobutamine side effect.CONCLUSIONS Dobutamine ^(99m)Tc-MIBI myocardial perfu- sion imaging is a safe and sensitive method in the diagnosis of coronary heart disease.