摘要
目的探讨静息单光子发射断层(SPECT)门控心肌灌注显像下冠心病患者左心功能水平与冠状动脉狭窄程度的相关性。方法选择2016年1月至2017年4月行冠脉造影检查的58例患者为研究对象,其中冠状动脉或主要分支血管管腔狭窄≥50%的患者42例(冠心病组),冠状动脉管腔狭窄<50%或无狭窄的患者16例(对照组)。所有患者均行门控心肌灌注显像获心功能参数:高峰充盈率(PFR)、左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、1/3平均充盈率(MFR/3)、高峰充盈时间(TTPF)。比较冠心病组及对照组组间心功能水平及其他临床资料。根据Gensini评分积分(积分越高冠状动脉病变程度越重)结果,将58例患者分为A组(Gensini积分<2.0,n=12)、B组(2.0≤Gensini积分<9.5,n=17)、C组(9.5≤Gensini积分<47.0,n=14)和D组(Gensini积分≥47.0,n=15),进行四组间心功能水平的比较。结果冠心病组较对照组年龄更大、女性患者已绝经时间更久(P<0.01,P<0.05);冠心病组MFR/3低于对照组(P<0.05),PFR、LVEF、LVESV、LVEDV、TTPF两组间无统计学差异(P均>0.05)。与A、B、C三组比较,D组PFR、LVEF、MFR/3值显著降低,LVEDV、LVESV显著增高,差异有统计学意义(P均<0.05);而A、B、C三组间心功能参数无统计学差异(P均>0.05)。相关分析显示,Gensini积分与PFR、LVEF、MFR/3呈显著负相关(P均<0.01),与LVEDV、LVESV、门控心肌灌注评分呈显著正相关(P均<0.01)。结论门控心肌灌注显像是目前唯一可以通过一次检查同时评估心肌灌注和左心室功能的影像检查技术,有广泛的临床应用价值。
Objectives To assess the correlation between coronary artery stenosis and left ventricular function using resting single photon emission computed tomography（ SPECT）-gated myocardial perfusion imaging（ G-MPI） in patients with coronary artery disease. Methods A total of 58 patients undergoing coronary angiography between January 2016 and April 2017 were selected and were divided into coronary heart disease（ CHD） group（ n = 42） in which patients were with stenosis of 50% or more and control group（ n = 16） in which patients were with stenosis less than 50% or without stenosis.By G-MPI,the cardiac function parameters including peak filling rate（ PFR）,left ventricular ejection fraction（ LVEF）,left ventricular end diastolic volume（ LVEDV）,left ventricular end systolic volume（ LVESV）,one-third mean filling rate（ MFR/3）,the time to peak filling（ TTPF） were obtained. The cardiac functions and other clinical data were compared between two groups. According to Gensini score（ the higher the score,the more serious the degree of coronary artery disease）,all patients were divided into group A（ Gensini score 2. 0,n = 12）,group B（ 2. 0 ≤Gensini score 9. 5,n =17）,group C（ 9. 5 ≤ Gensini score 47. 0,n = 14） and group D（ Gensini score ≥47. 0,n = 15） in which intra-group comparison of the cardiac function was conducted. Results The patients of CHD group were older than that of control group,and the female patients had a longer Menopause（ P〈0. 01,P〈0. 05）. The MFR/3 in CHD group was lower than that in control group（ P〈0. 05）,but there were no significant differences in PFR,LVEF,LVESV,LVEDV and TTPF between the two groups（ all P〈0. 05）. Compared with group A,B,and C,the values of PFR,LVEF and MFR/3 decreased significantly,and LVEDV and LVESV increased significantly in group D（ all P〈0. 05）,however,there were no significant differences in these indexes among group A,B,and C（ all P〈0. 05）. Correlation analysis showed that Gensini score was negatively correlated with PFR,LVEF,MFR/3（ all P〈0. 01）,and positively correlated with LVEDV,LVESV and gated myocardial perfusion imaging score（ all P〈0. 01）. Conclusions Gated myocardial perfusion imaging currently is the only imaging technique that can simultaneously assess myocardial perfusion and left ventricular function through a single examination. It has an extensive clinical application value.
作者
傅宁
鹿存芝
鹿峰
王亚楠
吴倩
朱萍
FU Ning;LU Cun-zhi;LU Feng;WANG Ya-nan;WU Qian;ZHU Ping(Department of Nuclear Medicine,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China)
出处
《中国临床研究》
CAS
2018年第7期893-896,共4页
Chinese Journal of Clinical Research
关键词
冠心病
冠状动脉造影
门控心肌灌注显像
左心功能
GENSINI评分
Coronary heart disease
Coronary angiography
Gated myocardial perfusion imaging
Left ventricularfunction
Gensini＇s score
