冷诱导心肌SPECT与UCG对诊断系统性硬皮病心肌损害的对比研究

Comparison of SPECT myocardial scans and echocardiography by cold-induced in detecting myocardial lesions of patients with systemic sclerosis

目的：探讨SPECT心肌显像和超声心动图（UCG）冷诱导对诊断系统性硬皮病（SSC）心肌损害的临床价值。方法：应用99mTc－MIBI对23例SSC病人进行SPECT心肌显像冷诱导，并同期进行UCG冷诱导检测。结果：①14例病人（6O．9%）至少有一处心肌放射性分布异常，4例病人（17.4%）于UGG示局部室壁运动低下，P＜0．05.②SPECT阳性率在雷诺现象(RP)组和无RP组之间无显著性差异（0．5＞P＞0．25）。③SPECT异常组病人的左室射血分数、每搏输出量、心输出量在冷诱导即时较试验前显著降低（P＜0．05），且与SPECT正常组比较也有显著性降低（P＜0．05）。结论：心肌SPECT冷试验可早期检出SSC病人的心肌损害，对这类病人的治疗效果和预后判断可以提供可靠的检测方法。

Objictive:To assess the clinical diaguostic value of myocardial SPECT and echocardiography on cold-induced in patients of systemic sclerosis(SSC) with myocardial involvement.Method:The study was performed with 99mTc-MIBI myocardial SPECT and echocardiography on cold-induced in 23 Patients with SSC. Result:① 14 Patients(60. 9%) had at least one regional defort of myocardial perfusion on SPECT; and 4 Paients (17. 4% ) had regional ventricular wall hypokinesis on UCG, P<0. 05. ②The positive on SPECF by cold-induced was not significant differences between patients with and without Raynaud's phenomenon (O. 5>P> 0. 25). ③Compared with baseline,the ejection fraction,stroke volume, cardiac output were significantly decreased during cold-induced in patients with abnormal myocardial SPECT(P < 0. 05), and reduced also than those with normal scintigraphy(P < 0. 05). Conclusion:Myocardialperfusion abnormalities could be addessed earlier in patients with systemic sclerosis using myocardial SPECT by cold-induced.It will be a reliable method for the evaluation of therapies and prognosis.