运动试验^(99m)Tc-MIBI心肌灌注显像正常在冠状动脉造影确诊的冠心病患者中的预后价值

Prognostic value of normal exercise ^(99m)Tc-MIBI myocardial SPECT in patients with angiographic coronary artery disease

目的 评价经冠状动脉造影确诊而运动试验99mTc MIBI(甲氧基异丁基异腈 )心肌灌注显像正常的冠心病患者的预后。方法 选择运动试验99mTc MIBI心肌灌注显像正常 ,而冠状动脉造影证实存在明显的主要冠状动脉狭窄 (≥ 5 0 % )的冠心病患者 6 4例 [男性 5 3例 ,女性 11例 ,平均年龄(5 6± 8)岁 ];另外选择运动试验99mTc MIBI心肌灌注显像和冠状动脉造影均正常的患者 6 7例作为对照组 [男性 4 5例 ,女性 2 2例 ,平均年龄 (5 2± 9)岁 ]。对上述两组患者的临床、冠状动脉造影及心肌灌注显像资料进行回顾性分析并进行随访。结果 在 18～ 10 1(5 0± 19)个月的随访期内 ,冠状动脉造影异常组和正常组分别有 2例和 1例发生心脏事件 (均为非致死性心肌梗死 ) ,两组患者的年心脏事件发生率分别为 0 8%和 0 3% (χ2 =0 77,P =0 38)。结论 运动试验99mTc MIBI心肌灌注显像正常的冠心病患者有着良好的预后 。

Objective Previous studies have documented the prognostic value of normal exercise 201 Tl myocardial perfusion imaging in patients with angiographic coronary artery disease (CAD). However, data on the value of exercise 99m Tc MIBI myocardial SPECT is scanty. This study was aimed to investigate the prognostic value of normal exercise 99m Tc MIBI SPECT in patients with angiographically significant CAD. Methods Sixty four consecutive patients who had a normal exercise 99m Tc MIBI myocardial SPECT but angiographically significant CAD (≥50% luminal diameter stenosis) were included. These patients were compared with a group of 67 consecutive patients with both a normal exercise 99m Tc MIBI myocardial SPECT and angiographically normal coronary artery. All those patients were followed up(mean 50±19 months). Results During the follow up period, there were only three cardiac events (nonfatal myocardial infarctions). The annual cardiac event rate of the two groups was similar (0 8% vs 0 3%, χ 2=0 77, P =0 38).Conclusions Our data demonstrate that a normal exercise 99m Tc MIBI myocardial perfusion SPECT suggests good prognosis despite of angiographic CAD.