运动-静息^(99)Tc^m-MIBI心肌灌注断层显像评价心肌桥患者心肌缺血的可靠性分析

Reliability of exercise- rest ^(99)Tc^m- MIBI myocardial perfusion imaging(MPI) in assessing the myocardial ischemia in patients with myocardial bridging

目的分析应用运动-静息99Tcm-MIBI心肌灌注断层显像评价心肌桥患者心肌缺血的可靠性。方法入选患者均行选择性冠状动脉造影术(CAG)、运动-静息99Tcm-MIBI心肌灌注断层显像(myocardial perfusion imaging,MPI)及运动心电图检查,心肌桥严重程度以Nobel分级表示,心绞痛症状以CCS分级表示。通过比较MPI及运动心电图诊断心肌桥患者心肌缺血的阳性率评估两者的敏感性。结果 MPI诊断心肌桥患者心肌缺血阳性率明显高于运动心电图(P<0.05),NobelⅢ级患者经MPI诊断心肌缺血阳性率明显高于NobelⅡ级和Ⅰ级(P<0.05),CCSⅢ级患者经MPI诊断心肌缺血阳性率明显高于CCSⅡ级和CCSⅠ级(P<0.05)。结论 MPI能够判断心肌桥患者心肌缺血,其敏感性明显优于运动心电图。

Objective To evaluate reliability of exercise -rest 99 Tcm -MIBI myocardial perfusion imaging（MPI）in assess-ing the myocardial ischemia in patients with myocardial bridging.Methods All selected patients underwent the coronary angiog-raphy,MPI and exercise electrocardiogram（ECG）,the severity of myocardial bridging was evaluated by the Nobel Grading stand-ard,and the symptom of angina was evaluated by CCS grading standard.The positive rate of myocardial ischemia in patients with myocardial bridging was evaluated by the MPI and exercise ECG. Results The positive rate of myocardial ischemia diagnosed by＆amp;nbsp;MPI was much higher than exercise ECG（P 〈0.05）,patients with Nobel Ⅲ level had a higher positive rate than patients with NobelⅠlevel（P 〈0.05）,patients with CCS Ⅲ level had a higher positive rate of myocardial ischemia diagnosed by MPI than patients with CCSⅠlevel and CCS Ⅱ level（P 〈0.05）.Conclusion MPI could evaluate the myocardial ischemia more sensi-tively than exercise ECG in patients with myocardial bridging.