核素心肌灌注显像与超声心动图测定青海地区老年冠心病患者心功能的对比研究

摘要

Objective To evaluate the effectiveness of ultrasonic cartography(UCG) and single photon emission computed tomography (SPECT) in measurement of the cardiac function of the elderly patients with coronary heart disease in Qinghai Plateau. Methods 240 coronary heart disease patients were tested by UCG and SPECT. The result of SPECT in group A(120 cases) was myocardial ischemia;in group B(92 cases) ,a small area of myocardial infarctionjin group C(28 cases) ,a large area of myocardial infarction. The two methods were compared to test the correlation and identity in measuring LVEF, and the sensitivity and specificity in group C. Results There was good correlation of LVEF measured with two tests in group A(r=0. 71,P<0. 05) and group B(r=0. 69,P<0. 05) ,but there was no correlation(r=0. 71 ,P>0. 05) in group C There were no significant differences of sensitivity and specificity in group A and group B. SPECT was more sensitive than UCG, but UCG was more special than SPECT in group C. Conclusion In Qinghai Plateau,patients with coronary heart disease,myocardial ischemia,and a small area of myocardial infarction may clinically refer to LVEF measured by UCG. The patients with myocardial infarction of multiple segments should adopt the SPECT test to get a more accurate LVEF value and myocardial perfusion status.%目的 评价超声心动图( ultrasonic cardiography,UCG)与核素心肌灌注单光子发射计算机断层摄影(single photon emission computed tomography,SPECT)测定青海地区老年冠心病患者心功能的价值.方法 选择老年冠心病患者240例,分别进行UCG和SPECT检测.根据SPECT显示的结果分为A组120例:心肌缺血；B组92例:小面积心肌梗死；C组28例:大面积心肌梗死.比较2种方法测定LVEF的相关性和一致性.结果 2种检测方法测得的LVEF在A组(r=0.71,P＜0.05)、B组(r=0.69,P＜0.05)有较好的相关性,而在C组无相关性(r=0.71,P＞0.05).A组与B组敏感性和特异性无明显差异.C组SPECT敏感性高于UCG,UCG特异性高于SPECT.结论 青海地区老年冠心病患者中,心肌缺血和小面积心肌梗死者,临床上可以参考UCG测得的LVEF；而有多个节段的大面积心肌梗死患者宜采用SPECT检测,以获得更准确的LVEF值和心肌灌注状况.