静息^(99m)Tc-MIBI心肌灌注显像估测心肌梗塞患者预后的价值

Prognostic Value of Rest Myocardial Perfusion Imaging in Patients with Myocardial Infarction

目的 :探讨99mTc-MIBI静息心肌灌注显像估测心肌梗塞患者预后的价值。材料与方法 :追踪了 74例行99mTc -MIBI静息心肌灌注显像的心肌梗塞患者 ,随访时间 4～ 36月 ,平均 2 3月 ,未发生心脏事件者随访时间≥ 12月。心脏事件包括 :心源性死亡 ,非致死性心肌梗塞 ,心肌显像三月后的血运重建术 (CABG或PTCA)。结果 :74例心肌梗塞患者随访中发生心脏事件 2 3例 ,总发生率为 31 1%。多因素Cox回归分析表明 ,心肌显像心肌灌注缺损节段数与发生心脏事件有密切关系 (P <0 0 0 1)。 31例心肌灌注缺损节段数≥ 4的心肌梗塞患者心脏事件发生率为 6 1 3% ,明显高于 43例心肌灌注缺损节段数≤ 3心肌梗塞患者的 9 3% (x2 =2 2 73 P <0 0 0 1)。单因素时序检验 (Log -rank)显示 ,两者未发生心脏事件率差异有显著性 (x2 =14 6 4 P <0 0 0 1)。结论 :99m Tc

Purpose:To evaluate the prognostic value of 99m Tc-MIBI rest myocardial perfusion tomography in patients with myocardial infarction(MI).Materials and Methods:74 patients with MI underwent 99m Tc-MIBI rest myocardial perfusion tomography(SPECT).The mean follow-up period was 23 months(rang 4～36 months)and even longer than 12 months for patients with no cardiac events(CE).Death due to primary cardiac cause,or nonfatal acute myocardial infarction and CABG or PTCA occurring>3 months after rest myocardial perfusion imaging were considered CE.Results:During follow-up there were 23 CE.Cox regression analysis revealed that there was a good correlation between the number of myocardial perfusion defects at rest myocardial perfusion imaging and future CE(P<0 001).CE occurred in 61 3% patients with the number of myocardial perfusion defects≥4 segments,compared with 9 3% patients with the number of myocardial perfusion defects≤3 segments (P<0 001).patients with the number of myocardial perfusion defects≥4 segments had a significantly lower no-CE rates than those with the number of myocardial perfusion defects≤3 segments(P<0 001).Conclusion:In patients with MI,The number of myocardial perfusion defects at 99m Tc MIBI rest myocardial perfusion tomography is the better predictor of future CE.