冠状动脉慢血流患者的腺苷负荷心肌灌注显像研究

Adenosine stress myocardial perfusion tomographic imaging in patients with coronary slow flow

目的:评价腺苷负荷心肌灌注单光子发射计算机断层扫描(SPECT)在诊断冠状动脉慢血流(CSF)中的临床价值。方法:根据冠状动脉造影(CAG)结果不同,分为CSF组、正常血流(NCF)组和CAG阳性组。使用校正的TIMI血流分级方法评价冠状动脉血流速度。3组均行CAG、静息心电图(ECG)、腺苷负荷ECG、静息及腺苷负荷SPECT检查,评价其心肌血流灌注情况。结果:CSF组腺苷负荷SPECT诊断心肌缺血阳性率(84%),明显高于平静ECG(20%)及腺苷负荷ECG(52%)。CSF组在腺苷负荷SPECT中显示心肌缺血的范围和程度高于NCF组,低于CAG阳性组。结论:CSF与心肌缺血关系密切,腺苷负荷SPECT可以作为检测CSF者心肌缺血的一种有效的无创性检查方法。

Objective：To assess the diagnostic value of adenosine 99mTc-MIBI myocardial perfusion SPECT in coronary slow flow （CSF） phenomenon.Method：The patients were divided into 3 groups according to their coronary angiography results,including the CSF group,normal coronary flow（NCF） group and coronary artery stenosis group. Coronary flow patterns of the cases were determined by corrected thrombolysis in myocardial infarction （TIMI） frame count（CTFC） method. CAG,resting electrocardiograph（ECG）,adenosine stress ECG,rest and adenosine myocardial perfusion SPECT were performed in all patients. Result：The positive rate of CSF in adenosine stress myocardial perfusion SPECT was significantly higher than on adenosine stress ECG and rest ECG（P〈0.05）. The scope and degree of myocardial ischemia on adenosine myocardial perfusion SPECT was coronary artery stenosis group 〉CSF〉NCF pattern（P〈0.01）. Conclusion：There is a direct relationship between CSF phenomenon and myocardial ischemia. Adenosine myocardial perfusion SPECT is considered as an useful non-interventional method for detecting patient＇s myocardial ischemia with CSF.