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目的 :通过观察运动 99m Tc- MIBI心肌断层显像试验中血压变化规律 ,探讨其与心肌灌注异常的关系及其预测价值。方法 :选择 1996～ 1998年进行运动 99m Tc- MIBI心肌扫描患者 2 0 4例 ,根据其结果分为显像阳性组12 2例及阴性对照组 82例 ,对运动前、运动高峰及运动终止后的血压进行监测 ,并计算运动后恢复期收缩压反应(SBPR)及舒张压反应 (DBPR)。结果 :两组间在年龄、性别、冠心病危险因素及基础血压值等方面均无显著性差异 (均 P >0 .0 5 )。显像阳性组与阴性对照组相比 ,前者运动后 3min收缩压〔(147± 2 3∶ 139± 19) m m Hg,P =0 .0 11〕及 SBPR(0 .841± 0 .140∶ 0 .76 8± 0 .10 1,P <0 .0 0 0 1)明显增高。对心肌灌注异常的预测 ,以 SBPR大于均值 (0 .77)的敏感性 (6 5 .6 % )较高 ;SBPR大于均值加 2个标准差 (>0 .87)的特异性最高 (84.1% ) (均 P<0 .0 2 5 )。结论 :核素心肌灌注缺血或梗死患者 SBPR升高具有一定的临床预测价值
OBJECTIVE: To investigate the relationship between the changes of blood pressure and myocardial perfusion in 99m Tc-MIBI myocardial perfusion imaging and their predictive value. Methods: Totally 204 cases of 99m Tc-MIBI myocardial perfusion imaging were selected from 1996 to 1998. According to the results, they were divided into two groups, 122 in positive imaging group and 82 in negative control group. Before exercise, peak exercise and end of exercise Blood pressure was monitored and systolic blood pressure (SBPR) and diastolic blood pressure (DBPR) were calculated after exercise recovery. Results: There was no significant difference between the two groups in age, gender, risk factors of coronary heart disease and baseline blood pressure (all P> 0.05). Imaging positive group compared with the negative control group, the former 3min after exercise systolic blood pressure (147 ± 2 3:139 ± 19) mm Hg, P = 0.011〕 and SBPR (0 .841 ± 0 .140: 0 .76 8 ± 0. 10 1, P <0 0 0 1) was significantly higher. The predictive value of myocardial perfusion abnormality was higher than that of SBPR (0.77%) (6.56%). SBPR was greater than the mean plus 2 standard deviations (> 0.87) with the highest specificity (84.1% ) (All P <0. 0 2 5). CONCLUSIONS: Increased SBPR in patients with radionuclide myocardial ischemia or infarction has certain clinical predictive value