多巴酚丁胺负荷与运动试验^(99m)Tc—MIBI心肌断层显像诊断冠心病的对比研究

Comparison of dobutamine loading and exercise tolerance tests for 99m Tc—MIBI myocardial tomographic diagnosis of CHD

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，３５ 例患者行运动负荷试验后进行心肌图像采集，次日再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９９ｍＴｃ—甲氧异腈（ＭＩＢＩ），之后行心肌图像采集，４８ｈ 再行静息态心肌显像。２０ 例冠心病患者中１８ 例多巴酚丁胺负荷试验阳性，１５ 例非冠心病患者中１ 例阳性，其特异性为９３－３％ ，灵敏度为９０％ ，无１ 例因多巴酚丁胺副作用而停止试验。在多巴酚丁胺与运动负荷配对比较中，二者检出率无显著性差异。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。

To compare dobutamine and exercise tolerance tests for 99m Tc—Methoxyisobutyl Isonitrile (MIBI) myocardial tomographic diagnosis of coronary heart disease (CHD),in 35 patients, 99m Tc MIBI myocardial tomograms were taken,first after exercise stress;the next day,after loading test of dobutamine given by pump of intravenous incremental micro dose infusion;and at rest,48 hours after dobutamine test.The results showed that after dobutamine test,18 of 20 CHD patients (90%) were positive results of tomography;1 of 15 non CHD patients was positive (14/15=93.3%).No patient suspended the test because of dobutamine side effects.There was no significant difference in CHD detectable rate between dobutamine loading test and exercise tests.Dobutamine tolerance test 99m Tc—MIBI myocardial tomography is a safe and sensitive method for diagnosis of coronary heart disease.