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目的 评价腺苷负荷试验心肌灌注显像诊断冠心病的准确性。方法 对 89例临床疑诊冠心病患者 ,分别静脉注射腺苷 ,剂量为 14 0 μg·kg-1·min-1,用药时间 6min(总剂量为 0 8mg/kg) ,注射过程中 ,行心电监测 ,观察患者的症状、血压和心率 ,于注射腺苷 3min末 ,静脉注射核素显像剂99mTc MIBI 92 5MBq ,1h后行心肌灌注断层显像 ,若显像异常 ,次日行静息心肌显像。所有患者行冠状动脉造影。结果 在 89例患者中 ,31例冠状动脉造影显示明显的冠状动脉狭窄病变 ,其中单支病变 10例 ,二支病变 11例 ,三支病变 10例。累及左前降支 2 8支 ,左回旋支 18支 ,右冠状动脉 16支 ,左主干 2支。腺苷负荷试验心肌灌注显像诊断冠心病的敏感性为 71%、特异性为 91%、阳性预测值81%、阴性预测值 84 %、准确性为 84 %。诊断单支、二支和三支冠状动脉病变患者的敏感性分别为5 0 %、73%、90 %。腺苷负荷试验心肌灌注显像判断血管病变的敏感性 77%、特异性 96 %、准确性 92 %。结论 腺苷负荷心肌灌注显像诊断冠心病敏感性及特异性均较高 ,具有重要的临床应用价值。
Objective To evaluate the accuracy of adenosine stress test myocardial perfusion imaging in the diagnosis of coronary heart disease. Methods A total of 89 patients with clinically suspected coronary heart disease were injected intravenously with adenosine at a dose of 14 0 μg · kg-1 · min-1 for 6 min (total dose of 0 8 mg / kg). During injection, Electrical monitoring was performed to observe the patient’s symptoms, blood pressure and heart rate. At the end of 3 min injection of adenosine, 99mTc MIBI 92 5MBq was injected intravenously, and myocardial perfusion tomography was performed 1h later. If the imaging was abnormal, Myocardial imaging. All patients underwent coronary angiography. Results Among the 89 patients, 31 cases of coronary angiography showed obvious coronary artery stenosis, including 10 cases of single vessel disease, 11 cases of two vessel disease and 10 cases of three vessel disease. Involved in the left anterior descending artery 28, 18 left circumflex artery, right coronary artery 16, 2 left main trunk. Adenosine stress test myocardial perfusion imaging diagnostic sensitivity of coronary heart disease was 71%, specificity was 91%, positive predictive value of 81%, negative predictive value of 84%, the accuracy of 84%. The diagnostic sensitivity of single, two and three coronary artery lesions were 50%, 73%, 90%. Adenosine stress test myocardial perfusion imaging to determine the sensitivity of vascular lesions 77%, specificity 96%, accuracy 92%. Conclusion adenosine stress myocardial perfusion imaging diagnosis of coronary heart disease sensitivity and specificity are high, has important clinical value.