SPECT对肺癌患者围手术期心肺功能评估的临床意义

The clinical significance of SPECT images for evaluation of perioperative cardiopulmonary function of patients with lung cancer

目的:对围手术期肺癌患者行超声心动图检测及SPECT心肌灌注显像检查,评价SPECT心肌灌注显像对围手术期肺癌患者心脏功能的临床价值。方法:选取行手术治疗的63例肺癌患者,于术前及术后10 d行超声心动图检测及SPECT心肌灌注显像和SPECT肺部灌注显像检查,比较1 s用力呼气容积(FEV1)指标,分析肺灌注显像FEV1预测值与肺功能分析仪实测值的相关性等。结果:患者放射治疗后心肌灌注显像SPECT、心电图和超声心动图的心肺功能异常率均明显高于放射治疗前(x^2=3.804,x^2=4.203,x^2=2.577;P<0.05);SPECT、心电图和超声心动图的检查异常率比较无统计学意义(x^2=0.912,P>0.05);肺灌注显像FEV1预测值与肺功能分析仪实测值无差异,且具有明显的正相关关系(r=0.6843,P<0.05)。结论:使用SPECT影像能够有效评估肺癌患者围手术期实行放射治疗对心肺功能的影响,临床检查准确率高。

Objective： To explore the clinical value of SPECT in perioperative cardiopulmonary function evaluation of patients with lung cancer through echocardiography and SPECT detection. Methods： 63 patients were selected to receive echocardiography, SPECT myocardial perfusion imaging and SPECT lung perfusion imaging detection before and after 10 days. To compare forced expiratory volume in one second（FEV1） and analyze the correlativity between the predictive value of lung perfusion imaging FEV1 and the real value detected by lung function instrument. Results： Abnormal rates of cardiopulmonary function on SPECT myocardial perfusion imaging, electrocardiogram and echocardiogram were significant higher after radiotherapy than those before radiotherapy（x^2=3.804, x^2=4.203, x^2=2.577, P〈0.05）. The abnormal rates among of SPECT, electrocardiogram and echocardiogram was not statistically significant（x^2=0.912, P〉0.05）. There was no statistical significant between predict value of lung perfusion imaging FEV1 and the real value of lung function, and the positive correlation between them was statistical significant（r=0.6843, P〈0.05）. Conclusion： SPECT imaging can effectively evaluate the effect of radiotherapy for cardiopulmonary function of patients with lung cancer in perioperative and its accuracy rate is higher in clinical detection.