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目的评价多巴酚丁胺超声心动图负荷试验(DSE)和硝酸甘油介入99mTc-MIBI心肌灌注显像(SPECT)评价心肌存活性的价值。方法48例可疑冠心病患者,行CAG、DSE及SPECT检查,其中25例冠心病患者成功行经皮冠脉介入治疗(PCI),以PCI术后3个月室壁运动改善为检验标准,比较多巴酚丁胺超声心动图负荷试验及硝酸甘油介入SPECT检测存活心肌的准确性。结果多巴酚丁胺负荷超声与硝酸甘油介入的心肌灌注显像均可敏感的检测存活心肌。与DSE相比,硝酸甘油介入的SPECT具有较高的敏感性但特异性较低,差异有统计学意义(P<0.05)。结论多巴酚丁胺负荷超声与硝酸甘油介入的SPECT检测存活心肌各有特点,但DSE更具临床应用价值。
Objective To evaluate the value of dobutamine stress echocardiography (DSE) and nitroglycerin-mediated 99mTc-MIBI myocardial perfusion imaging (SPECT) in evaluating myocardial viability. Methods Forty-eight patients with suspected coronary heart disease underwent CAG, DSE and SPECT. Twenty-five patients with coronary artery disease underwent percutaneous coronary intervention (PCI) successfully. The improvement of parietal wall motion at 3 months after PCI was the standard of test, Efficacy of Buutamyl echocardiography in loading test and nitric glycerol intervention SPECT in detecting myocardial viability. Results Dobutamine stress and nitroglycerin-mediated myocardial perfusion imaging were sensitive to detect viable myocardium. Compared with DSE, nitroglycerin interventional SPECT has a higher sensitivity but a lower specificity, the difference was statistically significant (P <0.05). Conclusion Dobutamine stress and nitroglycerin intervention SPECT detection of each characteristic myocardial activity, but DSE more clinical value.