冠状动脉疾病危险因素与^(201)TI心肌灌注显像的相关性研究

Relation ship between risk factors for coronary artery disease and thallium-201 myocardial scintigraphy

目的探讨冠状动脉疾病(CAD)5种主要危险因素(高血压、糖尿病、高脂血症、肥胖及抽烟)与201TI心肌灌注显像结果的相关性。方法对346例可疑CAD者进行了201TI运动·延迟心肌灌注断层显像。根据有无CAD危险因素和危险评分的高低分为四组:无危组、低危组、中危组及高危组。结果在四组病人中,无危组、低危组、中危组及高危组的心肌灌注异常率分别为48.1%、70.6%、89%及100%。四组间相比有非常显著性差别(字2=49.6,P=0.0001)。在伴有CAD危险因素的病人中,危险评分与半定量评分、肺/心比值和节段异常数均呈显著的正相关性(r=0.167~0.458,P=0.001~ 0.0006)。结论CAD危险因素与201TI心肌显像有密切的相关性,对伴有CAD危险因素尤其是中重度危险因素的可疑CAD病人应常规行201TI心肌灌注断层显像检查。

Objective To investigate the relation of 5 major risk factors (hypertension, diabetes, hyperlipidemia, overweight, smoking) of coronary artery disease (CAD) to the findings from thallium-201 single photon emission computed tomography. Methods Exercise 201TI myocardial scintigraphy was performed in 346 patients with clinically suspected CAD, who were divided into no risk, low risk, moderate risk, and high risk groups, based on CAD risk scores. Results The rate of thallium-201 perfusion abnormalities in no risk, low risk, moderate risk, and high risk groups were 48.1%, 70.6%, 89% and 100%, respectively, showing significant difference between them (χ2=49.6,P=0.000 1). In patients with CAD risk factors, significant relation was found between the risk scores and semiquantitative scores, lung-to-heart ratios or segment abnormalities (0.133≤r≤0.450, 0.000 1≤P≤0.031). Conclusion A close relation between CAD risk factors and thallium-201 myocardial scintigraphy is found. Routine thallium-201 myocardial scintigraphy should be performed in patients clinically suspected of coronary artery disease with CAD risk factors, especially those with moderate to high risk factors.