[1]樊孝廉,舒毅,曾春平,等.99Tcm-MIBI门控心肌灌注显像在2型糖尿病无症状心肌缺血患者中的价值[J].国际放射医学核医学杂志,2016,40(3):171-174.[doi:10.3760/cma.j.issn.1673-4114.2016.03.002]
　Fan Xiaolian,Shu Yi,Zeng Chunping,et al.Significance of 99Tcm-MIBI gated myocardial perfusion imaging in patients with type 2 diabetes but without myocardial ischemia symptoms[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):171-174.[doi:10.3760/cma.j.issn.1673-4114.2016.03.002]
点击复制

99Tcm-MIBI门控心肌灌注显像在2型糖尿病无症状心肌缺血患者中的价值(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
40
期数:
2016年第3期
页码:
171-174
栏目:
出版日期:
2016-05-25

文章信息/Info

Title:
Significance of 99Tcm-MIBI gated myocardial perfusion imaging in patients with type 2 diabetes but without myocardial ischemia symptoms
作者:
樊孝廉1;  舒毅2;  曾春平2;  靳仓正3;  鲁胜男1;  古炎发1;  车莉莉4;  张爱芳1
1. 528200, 佛山, 南方医科大学附属南海医院, 佛山市南海区人民医院核医学科;
2. 528200, 佛山, 南方医科大学附属南海医院, 佛山市南海区人民医院内分泌科;
3. 528200, 佛山, 南方医科大学附属南海医院, 佛山市南海区人民医院放射科;
4. 528200, 佛山, 南方医科大学附属南海医院, 佛山市南海区人民医院电生理科
Author(s):
Fan Xiaolian1;  Shu Yi2;  Zeng Chunping2;  Jin Cangzheng3;  Lu Shengnan1;  Gu Yanfa1;  Che Lili4;  Zhang Aifang1
1. Department of Nuclear Medicine, the Affiliated Nanhai Hospital of Southern Medical University, People’s Hospital of Nanhai District, Foshan 528200, China;
2. Department of Endocrinology, the Affiliated Nanhai Hospital of Southern Medical University, People’s Hospital of Nanhai District, Foshan 528200, China;
3. Department of Radiology, the Affiliated Nanhai Hospital of Southern Medical University, People’s Hospital of Nanhai District, Foshan 528200, China;
4. Department of Electrophysiology, the Affiliated Nanhai Hospital of Southern Medical University, People’s Hospital of Nanhai District, Foshan 528200, China
关键词:
糖尿病; 2型; 心肌缺血; 门控心肌灌注显像; 99m锝甲氧基异丁基异腈
Keywords:
Diabetes mellitus; type 2; Myocardial ischemia; Gated myocardial perfusion imaging; Technetium Tc 99m sestamibi
DOI:
10.3760/cma.j.issn.1673-4114.2016.03.002
摘要:
目的 探讨门控心肌灌注显像应用于2型糖尿病无症状心肌缺血患者中的价值。方法 以83例经确诊的2型糖尿病并接受了门控负荷心肌灌注显像的患者作为2型糖尿病组,51名无糖尿病史及明确的心血管病史的受检者作为对照组。17节段法分析两组受检者的负荷及静息心肌灌注显像,由两位有经验的医师进行视觉分析结合5点评分法评估左心室缺血节段,对比软件自动评分法计算两组的负荷总积分、静息总积分和积分差值,并作统计分析。结果 两组受检者左心室均未出现固定性心肌灌注缺损节段;血流灌注异常节段的差异具有统计学意义(χ2=24.19,P < 0.05)。2型糖尿病组与对照组的负荷总积分和静息总积分之间的差异都具有统计学意义(t=7.13、3.15,P均<0.05);两组的积分差值比较差异无统计学意义(t=1.44,P > 0.05)。对照组的负荷总积分与静息总积分比较差异无统计学意义(t=1.795,P > 0.05);运动负荷后两组受检者左室射血分数的差异有统计学意义(t=-7.65,P < 0.05)。结论 门控负荷心肌灌注显像在2型糖尿病人群中的恰当利用对评估无症状心肌缺血是有价值的。
Abstract:
Objective To explore the significance of 99Tcm-MIBI gated myocardial perfusion imaging in patients with type 2 diabetes but without myocardial ischemia symptoms. Methods Eighty-three patients with confirmed type 2 diabetes represented the test group and underwent 99Tcm-MIBI gated myocardial perfusion imaging; 51 patients with neither type 2 diabetes nor history of cardiovascular diseases represented the control group and underwent the same examination. Each image of the left-ventricle myocardium was divided into 17 segments for semi-quantitative analysis. All the segments were evaluated in consensus by two experienced doctors. Results were scored using a five-point scoring system and then referred to the system software’s auto-scores. The summed stress score(SSS), summed rest score(SRS), summed difference score(SDS), left ventricular ejection fraction (LVEF), peak perfusion rate, and peak ejection rate were determined during both stress imaging and rest imaging. Results Nonreversible defects were not observed in the segments obtained from the two groups. However, the difference between the abnormal perfusion segments of the two groups was significant(χ2=24.19, P < 0.05); the difference between the SSS and SRS(t=7.13, 3.15, P < 0.05) of the two groups was also significant, but no difference was noted in the SDS(t=1.44, P > 0.05) of both groups. Moreover, no significant difference existed between the SSS and SRS in the control group(t=1.795, P > 0.05). By contrast, the difference in the post-stress LVEF between the two groups was significant(t=-7.65, P < 0.05). Conclusions Even without cardiac symptoms, patients with type 2 diabetes should undergo 99Tcm-MIBI gated myocardial perfusion imaging for further analysis.

参考文献/References:

[1] 赵倩, 李娟.糖尿病冠状动脉粥样硬化性心脏病的发病机制及核素心肌灌注显像的研究进展[J].国际放射医学核医学杂志, 2007, 31(3):132-135.DOI:10.3760/cma.j.issn.1673-4114.2007.03.002.Zhao Q, Li J.The progress of research on myocardial perfusion imaging in diabetic coronary disease[J].Int J Radiat Med Nucl Med, 2007, 31(3):132-135.
[2] Hansen CL, Goldstein RA, Akinboboye OO, et al.Myocardial perfusion and function:Single photon emission computed tomography[J/OL].J Nucl Cardiol, 2007, 14(6):e39-60[2016-3-25].http://dx.doi.org/10.1016/j.nuclcard.2007.09.023.DOI:10.1016/j.nuclcard.2007.09.023.
[3] 潘中允.临床核医学[M].2版.北京:人民卫生出版社, 2014:215-242.Pan ZY.Practice of nuclear medicine[M].2th ed.Beijing:People’s Medical Publishing House, 2014:215-242.
[4] Roos CJ, Djaberi R, Schuijf JD, et al.Relationship between vascular stiffness and stress myocardial perfusion imaging in asymptomatic patients with diabetes[J].Eur J Nucl Med Mol Imaging, 2011, 38(11):2050-2057.DOI:10.1007/s00259-011-1894-x.
[5] Grundy SM, Benjamin IJ, Burke GL, et al.Diabetes and cardiovascular disease:a statement for healthcare professionals from the American Heart Association[J].Circulation, 1999, 100(10):1134-1146.
[6] Chhabra L, Ahlberg AW, Henzlova MJ, et al.Temporal trends of stress myocardial perfusion imaging:Influence of diabetes, gender and coronary artery disease status[J].Int J Cardiol, 2016, 202(1):922-929.DOI:10.1016/j.ijcard.2015.09.020.
[7] 高玲, 贾鹏, 许守林.核素心肌灌注显像在无症状性心肌缺血诊断中的临床应用[J].山西医药杂志, 2010, 39(11):1010-1011.DOI:10.3969/j.issn.0253-9926.2010.11.005.Gao L, Jia P, Xu SL.Clinical value of nuclide myocardial perfusion imaging in the myocardial ischemia diagnosis of light and midrange coronary artery stenosis[J].Shanxi Med J, 2010, 39(11):1010-1011.
[8] 程建和, 王胜军.双源CT冠脉成像和核素心肌灌注显像在冠心病临床诊断中的对比研究[J].河北医学, 2015, 21(9):1461-1465.DOI:10.3969/j.issn.1006-6233.2015.09.017.Cheng JH, Wang SJ.Evaluation of dual-source CT coronary artery imaging and spect myocardial perfusion imaging for diagnosis of CAD[J].Hebei Med, 2015, 21(9):1461-1465.
[9] De Graaf MA, Roos CJ, Mansveld JM, et al.Changes in ischaemia as assessed with single-photon emission computed tomography myocardial perfusion imaging in high-risk patients with diabetes without cardiac symptoms:relation with coronary atherosclerosis on computed tomography coronary angiography[J].Eur Heart J Cardiovasc Imaging, 2015, 16(8):863-870.DOI:10.1093/ehjci/jev003.
[10] 韩萍萍, 颜珏.SPECT心肌灌注显像在糖尿病无症状性心肌缺血中的临床价值[J].国际放射医学核医学杂志, 2013, 37(6):385-388.Han PP, Yan J.Clinical value of SPECT myocardial perfusion imaging for diabetic patients with silent myocardial ischemia[J].Int J Radiat Med Nucl Med, 2013, 37(6):385-388.
[11] 娜姿·伊力哈木, 巴雅, 刘立水, 等.2型糖尿病患者无症状性心肌缺血心肌灌注显像的临床研究[J].新疆医科大学学报, 2014, 37(6):755-758.DOI:10.3969/j.issn.1009-5551.2014.06.028.NaZi-YLHM, Ba Y, Liu LS, et al.The clinical value of myocardial perfusion imaging in type 2 diabetes patient with silent myocardial ischemia[J].J Xinjiang Med Univ, 2014, 37(6):755-758.

相似文献/References:

[1]乌海飞,尹红燕,刘帅,等.胰岛β细胞的分子核医学显像进展[J].国际放射医学核医学杂志,2010,34(4):203.[doi:10.3760/cma.j.issn.1673-4114.2010.04.003]
　WU Hai-fei,YIN Hong-yan,LIU Shuai,et al.Progress in molecular nuclear medicine imaging of pancreatic beta cells[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(3):203.[doi:10.3760/cma.j.issn.1673-4114.2010.04.003]
[2]邹钢,胡晓蓉,李翠吟,等.妊娠糖尿病患者肿瘤坏死因子的动态变化与胰岛素抵抗的关系[J].国际放射医学核医学杂志,2009,33(2):93.[doi:10.3760/cma.j.issn.1673-4114.2009.02.009]
　ZOU Gang,HU Xiao-rong,LI Cui-yin,et al.Alteration of serum tumor necrosis factor-alpha level in gestational diabetes mellitus and correlation with insulin resistance[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(3):93.[doi:10.3760/cma.j.issn.1673-4114.2009.02.009]
[3]赵倩,李娟.糖尿病冠状动脉粥样硬化性心脏病的发病机制及核素心肌灌注显像的研究进展[J].国际放射医学核医学杂志,2007,31(3):132.
　ZHA Qian,LI Juan.The progress of research on myocardial perfusion imaging in diabetic coronary disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2007,31(3):132.
[4]赵红光,蔡露,龚守良.低剂量辐射与糖尿病[J].国际放射医学核医学杂志,2006,30(1):59.
　ZHAO Hong-guang,CAI Lu,GONG Shou-liang.Low dose radiation and diabetes mellitus[J].International Journal of Radiation Medicine and Nuclear Medicine,2006,30(3):59.
[5]武志芳.SPECT心肌灌注显像对糖尿病心肌缺血损伤的研究[J].国际放射医学核医学杂志,2004,28(3):105.
　WU Zhi-fang.The study of SPECT myocardial perfusion imaging in detecting myocardial ischemia of diabetic patient[J].International Journal of Radiation Medicine and Nuclear Medicine,2004,28(3):105.
[6]朱灿胜.放射性核素显像在糖尿病足诊治中的应用[J].国际放射医学核医学杂志,2000,24(4):145.
　ZHU Can-sheng.Radionuclide imaging in diagnosis and therapy of the diabetic foot[J].International Journal of Radiation Medicine and Nuclear Medicine,2000,24(3):145.
[7]董森懿,刘志翔,耿雅文,等.液体试餐核素胃排空显像对糖尿病患者胃排空功能的研究[J].国际放射医学核医学杂志,2017,41(3):178.[doi:10.3760/cma.j.issn.1673-4114.2017.03.004]
　Dong Senyi,Liu Zhixiang,Geng Yawen,et al.Research on gastric emptying in diabetic patients using radionuclide-labeled liquid test meal[J].International Journal of Radiation Medicine and Nuclear Medicine,2017,41(3):178.[doi:10.3760/cma.j.issn.1673-4114.2017.03.004]
[8]韩萍萍,颜珏.SPECT心肌灌注显像在糖尿病无症状性心肌缺血中的临床价值[J].国际放射医学核医学杂志,2013,37(6):385.[doi:10.3760/cma.j.issn.1673-4114.2013.06.015]
　HAN Ping-ping,YAN Jue.Clinical value of SPECT myocardial perfusion imaging for diabetic patients with silent myocardial ischemia[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(3):385.[doi:10.3760/cma.j.issn.1673-4114.2013.06.015]
[9]姚立新,李昨非,刘波,等.糖尿病患者肾小球滤过率和肾有效血浆流量的改变及影响因素分析[J].国际放射医学核医学杂志,2010,34(5):281.[doi:10.3760/cma.j.issn.1673-4114.2010.05.007]
　Yao Li-xin,Li Zuo-fei,Liu Bo,et al.Analyse of influence elements in the process of dynamic renal imaging to measure glomerular filtration rate and effective renal plasma flow in patients with type 2 diabetes mellitus[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(3):281.[doi:10.3760/cma.j.issn.1673-4114.2010.05.007]
[10]郭永铁,耿洁.双峰型胰岛素释放曲线的初步分析[J].国际放射医学核医学杂志,2010,34(6):359.[doi:10.3760/cma.j.issn.1673-4114,2010.06.011]
　GUO Yong-tie,GENG Jie.Preliminary analysis of bimodal insulin release curve[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(3):359.[doi:10.3760/cma.j.issn.1673-4114,2010.06.011]
[11]马藤,轩昂,张杰,等.2型糖尿病患者大脑静息葡萄糖代谢改变研究[J].国际放射医学核医学杂志,2018,(1):25.[doi:10.3760/cma.j.issn.1673-4114.2018.01.005]
　Ma Teng,Xuan Ang,Zhang Jie,et al.Changes in resting-state brain glucose metabolism in patients with type 2 diabetes[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(3):25.[doi:10.3760/cma.j.issn.1673-4114.2018.01.005]

备注/Memo

备注/Memo:
收稿日期:2016-03-11
基金项目:佛山市科技局2013年医学类科技攻关项目(201308215)
通讯作者:樊孝廉,Email:FANXL2@163.com
更新日期/Last Update: 1900-01-01