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评价99Tcm 甲氧基异丁基异腈 (MIBI)运动 静息心肌 (ST RE)SPECT显像对经皮冠状动脉腔内成形 (PTCA)术后判断疗效、预测再狭窄以及估测预后的临床价值。方法 10 0例PTCA术后患者行ST RESPECT ,30例有术前对照 ,30例复查冠状动脉造影 (CAG) ,被扩冠状动脉所支配的心肌显像如为可逆性 (RD)和 (或 )部分可逆性缺损 (PRD) ,提示心肌缺血 ,冠状动脉再狭窄可能。患者在随访期间如发生心源性死亡、急性心肌梗死、不稳定性心绞痛和行血运重建术 ,认为有心脏事件发生。结果 ① 10 0例患者中 2 8%有心肌缺血 ,心肌缺血的发生率在心肌梗死组和无心肌梗死组差异无显著性 ( 2 4 0 %和 2 4 7% ,P >0 0 5) ;② 30例患者中 ,术后心肌灌注的改善率为 76 7% ,其中 12例完全恢复正常 ;③对 30例患者共 4 5支被扩冠状动脉 ,ST RESPECT和心电图运动试验对再狭窄诊断的阳性预测值分别为 88 8%和 55 0 % ,阴性预测值分别为 85 1%和 64 0 % ,预测准确性分别为86 7%和 60 0 % ;④心脏事件发生率在缺血组和无缺血组分别为 4 6 4 % ( 13 2 8例 )和 1 4 % ( 1 72例 ) ,差异有极显著性 ( χ2 >2 4 3 ,P <0 0 0 0 1)。结论 99Tcm MIBIST RESPECT对PTCA术后疗效的判断、再狭窄的预测以及估测预后均有一定的临床价值
To evaluate the clinical value of 99Tcm myocardial interstitial fibrillation (SPECT) SPECT imaging in predicting therapeutic efficacy, predicting restenosis and prognosis after percutaneous transluminal coronary angioplasty (PTCA). Methods One hundred and ten cases of postoperative PTCA patients underwent ST RESPECT. Thirty patients had preoperative control and 30 patients underwent coronary angiography (CAG). Myocardial imaging such as RD and / Partial reversible defects (PRD), suggesting myocardial ischemia, coronary restenosis may be. During follow-up such as cardiac death, acute myocardial infarction, unstable angina, and revascularization, a cardiac event was considered. Results ① Myocardial ischemia occurred in 28% of the 10 patients. The incidence of myocardial ischemia was not significantly different between myocardial infarction group and non-myocardial infarction group (24.0% vs 24.7%, P> 0.05). ); 30 cases of patients, postoperative myocardial perfusion improvement rate was 76.7%, of which 12 cases returned to normal; ③ 30 patients with a total of 45 were enlarged coronary artery, ST RESPECT and ECG exercise test for restenosis The positive predictive value of diagnosis was 88.8% and 55.0%, respectively. The negative predictive values were 85.1% and 64.0%, respectively. The accuracy of prediction was 86.7% and 60.0% respectively. ④The incidence of cardiac events in the ischemic group And no ischemia group were 46.4% (132.8 cases) and 14% (172 cases), respectively. There was a significant difference between the two groups (χ2> 2 43, P 0 01 0). Conclusion 99Tcm MIBIST RESPECT has a certain clinical value in judging the curative effect of PTCA, predicting restenosis and estimating prognosis