核素心肌灌注显像对糖尿病微血管病变诊断的临床应用价值

The clinical application value of nuclide myocardial perfusion imaging in detecting diabetic microangiopathy

目的研究核素心肌灌注显像对诊断糖尿病(DM)微血管病变患者心肌缺血及预后评价的价值。方法 97例住院患者,其中男64例,女33例,经临床证实均为有不同程度心绞痛的DM微血管病变患者,冠状动脉造影(CAG)检查均为阴性(无异常和血管狭窄<50%),年龄45～85(57±13)岁。予核素心肌灌注显像,并对患者预后进行抽样临床随访。结果核素心肌灌注显像阳性、CAG阴性76例,核素心肌灌注显像与CAG均阴性21例。其中核素心肌灌注显像阳性患者预后均较阴性者差,其心脏事件发生率与缺血面积及严重程度呈正相关。结论核素心肌灌注显像对DM微血管病变的诊断和预后评价有重要意义。

Objective To study the clinical application value of nuclide myocardial perfusion imaging in diabetic microangiopathy. Methods The 97 hospitalized cases（64 males, 33 females）aged 45 - 85 （56.5 ±12. 5） years were diagnosed as angina plus diabetic microangiopathy with negative results of CAG （coronary arteriography）. They were examined by nuclide myocardial perfusion imaging. Partial patients were followedup. Results 76 cases had positive nuclide myocardial perfusion imaging and negative CAG. 21 cases had negative nuclide myocardial perfusion imaging and negative CAG. The prognosis was worse in positive versus negative nuclide myocardial perfusion imaging. The cardiac events were positively correlated with ischemic area and severity. Conclusions Nuclide myocardial perfusion imaging has an important clinical application value in diagnosis and prognosis of diabetic microangiopathy.