[1]卫华,李思进,刘建中,等.99Tcm-N-NOET负荷和延迟门控心肌灌注显像对高血压患者的临床价值[J].国际放射医学核医学杂志,2010,34(1):23-26.[doi:10.3760/cma.j.issn.1673-4114.2010.01.006]
　WEI Hua,LI Si-jin,LIU Jian-zhong,et al.The clinical value of 99Tcm-N-NOET exercise and delayed myocardial perfusion imaging in patients with hypertension[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(1):23-26.[doi:10.3760/cma.j.issn.1673-4114.2010.01.006]
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99Tcm-N-NOET负荷和延迟门控心肌灌注显像对高血压患者的临床价值(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
34
期数:
2010年第1期
页码:
23-26
栏目:
临床核医学
出版日期:
1900-01-01

文章信息/Info

Title:
The clinical value of 99Tcm-N-NOET exercise and delayed myocardial perfusion imaging in patients with hypertension
作者:
卫华;  李思进;  刘建中;  武志芳;  刘海燕;  胡光;  王进;  李清
030001, 太原, 山西医科大学第一医院核医学科
Author(s):
WEI Hua;  LI Si-jin;  LIU Jian-zhong;  WU Zhi-fang;  LIU Hai-yan;  HU Guang;  Wang Jin;  LI Qing
Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030001, China
关键词:
高血压; 心肌灌注显像; 99Tcm-双(N-乙氧基; N-乙基-二硫代氨基甲酸酯)氮化锝
Keywords:
Hypertension; Myocardial perfusion imaging; 99Tcm-bis(N-ethoxy-N-ethyl-dithiocarbamato)nitridotechnetium
DOI:
10.3760/cma.j.issn.1673-4114.2010.01.006
摘要:
目的 探讨99Tcm-双(N-乙氧基,N-乙基-二硫代氨基甲酸酯)氮化锝(99Tcm-N-NOET)负荷和延迟心肌灌注显像(MPI)对高血压患者的临床应用价值。方法 对60例高血压患者和19例正常对照者进行99Tcm-N-NOET负荷+延迟MPI,并对MPI、运动心电图、心功能参数[舒张末期容积(EDV)、收缩末期容积(ESV)、左室射血分数(LVEF)]、△LVEF (LVEF运动-LVEF延迟)及冠状动脉造影(CAG)结果进行相关分析。结果 ①高血压组60例患者中,22例(36.7%)运动中心电图阳性,16例(26.7%)运动中出现胸闷,13例(21.7%)运动中出现血压过度反应;对照组19例正常者中,2例(10.5%)运动心电图阳性,1例(5.3%)运动中出现胸闷,无运动中血压过度反应者。②高血压组MPI阳性率明显高于对照组(31.75%vs.5.30%,P<0.05)。③高血压组运动和延迟的心功能参数[运动EDV=(79.75±29.10) ml,ESV=(28.82±15.73) ml,LVEF=(65.78±1.27)%;延迟EDV=(81.42±3.47) ml,ESV=(30.62±2.05) ml,LVEF=(64.20±9.70)%]与对照组[运动EDV=(79.63±21.65) ml,ESV=(27.37±10.71) ml,LVEF=(66.42±1.55)%;延迟EDV=(82.89±4.96) ml,ESV=(31.42±3.06) ml,LVEF=(63.16±7.54)%]均无统计学差异(运动EDV:t=0.161,ESV:t=0.112,LVEF:t=0.261;延迟EDV:t=0.276,ESV:t=0.197,LVEF:t=0.184,P<0.05),高血压组△LVEF为负值者有28例(46.7%),对照组有4例(21.1%),χ2=3.929,P<0.05.MPI阳性而△LVEF为负值者有11例(57.9%),MPI阴性而△LVEF为负值者有12例(29.3%),χ2=4.501,P<0.05.④高血压患者中19例行CAG,结果:11例异常,8例正常;行MPI结果:9例缺血,10例正常。两者比较无统计学差异(χ2=0.25,P>0.05)。99Tcm-N-NOET MPI的灵敏度、特异度和准确率分别为72.7%、87.5%和78.9%。结论 ①99Tcm-N-NOET负荷+延迟MPI可用于诊断高血压患者是否伴有心肌缺血。②高血压患者的心功能储备降低,MPI阳性的高血压患者心脏储备功能更低。
Abstract:
Objective To investigate clinical significance of the 99Tcm-bis (N-ethoxy-N-ethyl-dithiocarbamato) nitridotechnetium(99Tcm-N-NOET) exercise and delayed myocardial perfusion imaging (MPI) in hypertensive patients. Methods Sixty patients with hypertension and 19 normal subjects were carried out 99Tcm-N-NOET exercise and delayed MPI, and analyzed the results of MPI, exercise electrocardiography (ECG), cardiac function parameters end-diastolic volume(EDV), end-systolic volume(ESV), left ventricular ejection fraction(LVEF), △LVEF (LV EF exercis-LVEF delay) and coronary angiography(CAG). Results ① Sixty patients with hypertension, 22 cases(36.7%)of exercise ECG were abnormal, 16 cases (26.7%)were the chest tightness in exercise, 13 cases (21.7%) were blood pressure excessive reaction in exercise; control group, 2 cases (10.5%) of exercise ECG were abnormal, 1 case (5.3%, 1/19) was chest tightness in exercise,no per-son was blood pressure response in excessive. ②The positive rate of myocardial perfusion in hyper tensive group was significantly higher than the control group (31.75% vs.5.30%, P<0.05). ③Cardial function parameters in hypertension group[exercise EDV=(79.75±29.10)ml, ESV=(28.82±15.73)ml, LVEF=(65.78±1.27)%; delay EDV=(81.42±3.47)ml, ESV=(30.62±2.05)ml, LVEF=(64.20±9.70)%] and control group[exercise EDV=(79.63±21.65)ml, ESV=(27.37±10.71)ml, LVEF=(66.42±1.55)%; delay EDV=(82.89±4.96)ml,ESV=(31.42±3.06)ml, LVEF=(63.16±7.54)%] were no statistical difference(exercise EDV:t=0.161, ESV:t=0.112, LVEF:t=0.261; delay EDV:t=0.276, ESV:t=0.197, LVEF:t=0.184, P>0.05), △LVEF<0%, 28 cases (46.7%) in hypertension group, 4 cases (21.1%) in control group, χ2=3.929, P<0.05; 11 cases (57.9%) in MPI positive group, 12 cases (29.3%) in MPI negative group, χ2=4.501, P<0.05. ④Nineteen hypertension underwent CAG, 11 cases were abnormal, 8 cases were normal. MPI results:9 cases were ischemia, 10 cases were normal, and they were no statistical difference (χ2=0.25, P>0.05). The sensitivity,specificity and accuracy of 99Tcm-N-NOET MPI were 72.7%, 87.5% and 78.9%. Conclusions ①99Tcm-N-NOET exercise and delayed MPI can diagnose whether hypertension patients with myocardial ischemia or not. ② △LVEF of hypertensive patients reduced, △LVEF is lower in hypertensive patients of MPI-positive.

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备注/Memo

备注/Memo:
收稿日期:2009-10-05。
通讯作者:李思进,E-mail:lisj-nm@sohu.com
更新日期/Last Update: 1900-01-01