药物负荷核素心肌灌注显影对冠心病的诊断价值

摘要

Objective To explore the diagnostic value of drug stress nuclide myocardial perfusion imaging ( MPI ) to coronary heart disease ( CHD ). Methods The patients ( n = 88 ) with suspected CHD were simultaneously given coronary angiography ( CAG ) and dipyridamole or adenosine stress nuclide MPI, and then they were given retrospective analysis. The difference was less than 14 days between CAG date and MPI date. Taking CAG results as golden criterion of CHD diagnosis, the sensitivity and specificity of drug stress nuclide MPI were compared and analyzed. Results The sensitivity, specificity and accuracy of drug stress nuclide MPI were, respectively, 91. 4% ,73. 3% and 85. 2% in the diagnosis of CHD. Among 5 false negative cases ,4 with single vessel lesion, 1 with double vessel lesion and all of them had good compensatory circulation. Among 8 false positive cases, 3 with syndrome X and 4 with slow coronary flow. Conclusion Drug stress nuclide MPI is an effective pathway for non-invasive diagnosis of CHD and myocardial ischemia. Most of patients with false positive or false negative have corresponding pathophysiological bases of coronary artery or cardial myodium.%目的 探讨药物负荷核素心肌灌注显像(MPI)对冠心病的诊断价值.方法 回顾性分析88例疑有冠心病且同时行冠状动脉造影(CAG)和双嘧达莫或腺苷药物负荷核素MPI患者,CAG与MPI检查日期相差不超过14 d,以CAG检查结果作为诊断冠心病的金标准,对比分析药物负荷核素MPI敏感度、特异性等指标.结果 药物负荷核素MPI诊断冠心病的敏感度、特异性、准确率分别为91.4%、73.3%、85.2%;在5例假阴性患者中,4例为单支病变,1例为双支病变,侧支循环均良好;8例假阳性患者中,3例为X综合征,4例为冠状动脉血流缓慢.结论 药物负荷核素心肌灌注显像是无创诊断冠心病及心肌缺血的有效途径,其假阳性和假阴性患者多有相应的冠状动脉或心肌的病理生理基础.