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目的 探讨心肌灌注显像异常对冠状动脉造影 (CAG)正常的高血压患者的临床意义。方法 应用99Tcm 甲氧基异丁基异腈 (MIBI)负荷与静息心肌灌注断层显像 (MPT)定性方法 ,及侧壁 间隔计数比值 (L S)和负荷L S与静息L S之再比值 ,比较了 2 1例CAG正常的高血压患者与 11例血压正常的对照者的结果。结果 ①高血压组MPT阳性率为 6 1 9% ,显著高于对照组的 9 1% ,P <0 0 1,且以可逆性缺损为主 ,伴有少数反向填充 ;其心绞痛与心律失常发生率也明显高于对照组。②高血压组与对照组相比 ,负荷L S与静息L S之再比值明显降低 ,P <0 0 5。③高血压组MPT阳性患者负荷L S与静息L S之再比值低于MPT阴性患者 ,P <0 0 1;MPT阳性者烟酒嗜好明显多于MPT阴性者 ,分别为 5 3 8%和 12 5 % ,P <0 0 5。④MPT异常分布于各个节段 ,大多数无明显心肌肥厚表现。结论 ①心肌灌注显像异常可以发生在CAG正常、有或无心肌肥厚的高血压患者中。②长期烟酒嗜好是高血压患者出现心肌缺血的危险因素之一。
Objective To investigate the clinical significance of abnormal myocardial perfusion imaging in hypertensive patients with normal coronary artery angiography (CAG). Methods 99Tcm methoxyisobutyl isonitrile (MIBI) load and resting myocardial perfusion tomography (MPT) qualitative method, and the sidewall spacer count ratio (LS) and load LS and resting LS ratio ratio of 2 1 case of normal CAG hypertensive patients and 11 cases of normotensive control results. Results ① The positive rate of MPT in hypertension group was 61.9%, which was significantly higher than that in control group (91.0%, P <0.01), and was mainly reversible, accompanied by a few reverse filling. Angina pectoris and arrhythmia The incidence was also significantly higher than the control group. ② Compared with the control group, the ratio of load L S to resting L S in hypertensive group was significantly lower (P <0.05). (3) The ratio of LS to resting LS in patients with MPT-positive hypertension was lower than that in patients with MPT negative (P <0.01); MPT-positive patients had more alcohol and tobacco alcohol abuse than those with negative MPT, which were 53.8% and 125 %, P <0 0 5. ④MPT abnormal distribution in all segments, most of the obvious no obvious cardiac hypertrophy. Conclusion ① myocardial perfusion imaging abnormalities can occur in patients with normal CAG, with or without cardiac hypertrophy in hypertensive patients. Long-term alcohol and tobacco addiction is one of the risk factors of myocardial ischemia in hypertensive patients.