冠心病门控心血池显像的临床评价

The clinical evaluation of the gated cardiac blood pool imaging in coronary heart disease

目的 :评价冠心病 (CHD)门控心血池显像各个参数的临床意义。方法 :选取因 CHD行门控心血池检查且临床资料齐全者 174例 ,根据临床资料分为缺血组和心肌梗死组 (每组 87例 ) ,对两组心室各功能参数进行分析。结果 :左室射血分数、高峰射血率、高峰充盈率在 CHD的表现为明显减低 ,且各自间相关 ,不论是在缺血组还是心肌梗死组都表现为呈平行性减低 ;左室舒张末期血压在 CHD缺血组和心肌梗死组均明显扩大 ;相角程虽对CHD诊断有一定意义 ,但并非 CHD的特异性指标 ,时相图通过图形能够形象、直观地显示局部心肌的收缩时相及功能 ,在心肌梗死定位诊断中有较大意义 ;收缩前期时间、高峰射血时间明显延长 ,提示心室功能受损 ;临床心功能分级在缺血和心肌梗死组的分布未见统计学差异 ,而门控心血池显像检查所测的各项指标两组间差异明显 ,心功能 3～ 4级时 ,各项参数较 1～ 2级者明显为差 ,但 1～ 2级间 ,3～ 4级间未显示出差异。结论 :临床心功能分级单依患者的临床表现尚存在一定的困难 ,而核素心血池显像能够用量化指标较为客观地提供患者的心功能状态。

Objective:This paper intends to evaluate clinical value of the gated cardiac blood pool imaging in coronary heart disease. Method:174 patients with coronary heart disease were divided into 2 (ischemic and myocardial infarction) groups (87 cases in each group),and were examined by the gated cardiac blood pool imaging. Using SOPHY DS7 SPECT, FRANKFURT processing, ventricle function index was obtained. Database and data analyses were found with Microsoft Excel. Result:LVEF, PER, PFR were decreased in coronary heart disease in both ischemic and myocardial infarction groups.There was significant relativity among them. EDV was observably increased.PSH had some clinical significance, but it was not differential index. Phase imaging can directly reflect systolic phase and function of regional heart muscle. It is important for orientation of the myocardial infarction. Therefore, both PSH and Phase imaging should be considered in phase analyses. PEP. TPE were observably prolonged. This indicated damage of the heart function.The distribution of clinical heart function classification was no difference between myocardial ischemia and myocardial infarction group,but there were difference about the ventricular function index of the gated cardiac blood pool imaging in two groups. When clinical heart function was 3~4 grade, the heart function parameters were poorer than that in 1~2 grade. There were no difference between 1 grade and 2 grade, as well as between 3 grade and 4 grade. Conclusion:There are some problems about clinical heart function classification if only depend on clinical expression. The gated cardiac blood pool imaging can objectively denote clinical heart function condition with quantitative index.It provides an effective method for judgement of the clinical heart function.