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目的 应用TMP ,CTFC ,maxSTE及sumSTR方法评价急性心肌梗死急诊介入治疗后心肌组织灌注并探讨其与临床预后的关系。方法 6 5例AMI急诊介入治疗后即刻采用TMP、CTFC及心电图(maxSTE ,sumSTR)方法评价心肌组织灌注,记录6个月心脏事件。结果 与双核素心肌灌注显像对比,检验每种评价方法的敏感性、特异性、准确性;maxSTE敏感性80 % ,特异性85. 7% ,准确性83 .1 % ;TMP敏感性73 3% ,特异性80 % ,准确性76 . 9% ;而CTFC( 4 0 ) ,CTFC( 30 ) ,sumSTR30 %和sum STR( 50 )预测价值较低。多变量回归分析显示TMP 0. 1级、maxSTE高危为6个月心脏事件的独立危险因子。结论 TMP ,maxSTE方法可以较好地评价心肌灌注程度,并对6个月临床预后有较好的预测价值。
Objective To evaluate myocardial perfusion after emergency interventional therapy in acute myocardial infarction (AMI) by using TMP, CTFC, maxSTE and sumSTR methods and to explore its relationship with clinical prognosis. Methods Sixty-five AMI patients were enrolled in this study. Myocardial perfusion was assessed by TMP, CTFC and maxSTE (sum electrocardiogram) method immediately after PCI. Six-month cardiac events were recorded. Results The sensitivity, specificity and accuracy of each evaluation method were compared with those of dual nuclide myocardial perfusion imaging. The maxSTE sensitivity was 80%, the specificity was 85.7%, the accuracy was 83.1%, the sensitivity of TMP was 73 3 %, Specificity 80%, and accuracy 76.9%. However, CTFC (40), CTFC (30), sumSTR30% and sum STR (50) had lower predictive value. Multivariate regression analysis showed that TMP 0. 1-level, maxSTE risk was an independent risk factor for 6-month cardiac events. Conclusion The TMP and maxSTE methods can evaluate myocardial perfusion well and have a good predictive value for 6-month clinical prognosis.