腺苷负荷试验门控心肌灌注单光子断层显像评价患者左心室功能的变化

Evaluation of Left Ventricular Functional Changes With Adenosine-Induced Vasodilator Stress by Gated Single Photon Emission Computed Tomography

目的:应用腺苷负荷试验门控心肌灌注单光子断层显像评价患者左心室功能的变化。方法:选取我院住院的冠心病患者70例行腺苷负荷试验+静息门控心肌灌注单光子断层显像及冠状动脉造影检查。根据患者腺苷负荷试验后左心室射血分数(LVEF)较静息时的变化情况将患者分为两组:LVEF降低≥5%组(n=16)和LVEF降低<5%组(n=54)。图像分析采用17节段半定量评分法,得到负荷灌注总评分、静息灌注总评分及心肌缺血总评分。应用QGS软件计算左心室功能参数:即左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)及左心室收缩末期容积(LVESV)。结果:LVEF降低≥5%组患者的静息时LVEF明显大于腺苷负荷试验后LVEF;与LVEF降低<5%组相比,LVEF降低≥5%组的负荷灌注总评分及心肌缺血总评均显增加,病变范围及冠状动脉狭窄程度更严重,差异均有统计学意义(P均<0.05)。结论:腺苷负荷试验后LVEF较静息时明显降低(≥5%)可作为诊断冠心病的一个重要而有效的证据。

Objective： To evaluate the left ventricular （LV） functional changes with adenosine-induced vasodilator stress by gated single photon emission computed tomography （SPECT）. Methods： A total of 70 patients with coronary artery disease （CAD） were studied, all patients were examined by rest and adenosine-induced stress SPECT and coronary angiography. According to their left ventricular ejection fraction （LVEF） changes between the rest and after stress, the patients were divided into 2 groups, LVEFrest-LVEFado≥ 5% group, n= 16, and LVEFrest-LVEFado〈5% group, n=54. The imaging was analyzed with 17 segment semi-quantified assessment for summed total scores of stress perfusion, rest perfusion, and myocardial ischemia respectively. QGS software was applied to calculate the LV functional parameters of LVEF, LVEDV and LVESV respectively. Results： In LVEFrest-LVEFado≥5% group, the patients＇ LVEFrest was obviously higher than that after LVEFado. Compared with LVEFrest-LVEFado〈5% group, the patients in LVEFrest-LVEFado ≥ 5% group presented higher summed total scores of stress perfusion, myocardial ischemia, and severer coronary stenosis with more lesions, P〈0.05 respectively. Conclusion： LVEFado reduction ≥ 5% is an important and effective evidence for CAD diagnosis.