摘要
目的:探讨冠脉造影(CAG)正常的II型糖尿病(NIDDM)患者SPECT心肌负荷显像特点及临床价值。方法:应用99Tcm-甲氧基异丁基异腈(MIBI)负荷门控心肌灌注断层显像(MPT)定性与半定量记分法,比较18例CAG正常的NIDDM患者(A组)及15例正常对照组(B组)运动负荷?静息心肌显像特点。结果:①A组负荷状态下有16例(16?18,88.8%)共计38个节段出现心肌血流灌注异常(其中可逆性缺损占16个节段,部分可逆性缺损18个节段,固定性缺损4个节段);B组15例受检者中有2例共计3个节段存在血流灌注异常(均为评分1分的可逆性缺损),与A组比较两者心肌出现血流灌注异常的机率差异显著(38?162,3?135;χ2=26.15,P<0.001)。②A组、B组左室射血分数(LVEF)测定值分别为64.9%±7.8%、71.6%±5.2%(t=3.641,P<0.01),两组之间差异显著。结论:NIDDM患者即使CAG检查是正常的,负荷状态下多数仍存在心肌血流灌注异常,并伴有一定程度的左室射血功能减低。
Objective To evaluate the feature and clinical significance of SPECT myocardial perfusion tomography(MPT) in non insulin dependent diabetes mellitus(NIDDM) with normal coronary angiography(CAG). Methods Qualitative and semi quantitative diagnosis from gated stress and rest 99Tcm sestamibi(MIBI) MPT were compared between 18 NIDDM and 15 normotensive controls(NC). Results ①The positive rate of MPT in NIDDM was obviously higher than that of NC which was 88.9%(1618) vs 13.3%(215) respectively. Most foci of MPT were reversible defects(1638) and partial reversible defects (1838). The positive rate of abnormal segments in NIDDM was obviously higher than that of NC(38162 3135 χ2=26.15 P<0.001). ②Analysis of heart functional data there was significant difference about LVEF between NIDDM and NC(64.9%±7.8% 71.6%±5.2% t=3.641 P<0.01). Conclusions Most NIDDM patients have stress MPT abnormal even without significant epicardial artery stenosis together with the systolic function of left ventricular slightly depressed.
出处
《中国临床医学影像杂志》
CAS
2004年第12期690-691,701,共3页
Journal of China Clinic Medical Imaging
