【摘要】 目的 探讨双核素心肌显像对急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI术后远期主要不良心血管事件（MACE）的预测价值。方法 自2015年1月至2020年12月，回顾性收集新疆医科大学第一附属医院就诊的AMI患者95例，随访3年，根据患者术后是否发生MACE事件分为MACE组（n=42）和对照组（n=53），比较两组患者临床特征和双核素心肌显像相关参数差异，分析双核素心肌显像相关参数对MACE事件的预测价值。结果 与对照组比较，MACE组患者糖尿病发生率显著增高（42.86%vs. 22.64%,P=0.035）；冠状动脉（冠脉）狭窄程度显著增高[（73.67±11.57）%vs.(66.11±8.69)%,P<0.001]；左心室射血分数（LVEF）显著降低（47.45±3.83 vs. 52.13±4.31,P<0.001）；心肌缺血总积分显著增高[（14.29±4.20）%vs.(9.89±3.33)%,P<0.001]；心肌灌注/代谢不匹配百分比显著增高（16.58±1.61 vs. 15.69±2.14, P=0.028）。LVEF对急性心肌梗死患者PCI术后MACE事件具有一定预测价值，曲线下面积（AUC）为0.777(95%CI:0.686～0.868,P<0.001)。冠脉狭窄程度、心肌缺血总积分对预测AMI患者PCI术后MACE事件具有一定预测价值，AUC分别为0.676、0.784。多因素Logistics回归分析显示LVEF<50%、心肌缺血总积分>12是AMI患者PCI术后3年内发生MACE事件的独立危险因素（P<0.05）。结论 双核素心肌显像相关参数可作为AMI患者PCI术后MACE事件的预测指标之一。更多还原

【Abstract】 Objective To investigate the predictive value of dual nuclide myocardial imaging to long-term major adverse cardiovascular events(MACE) in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI). Methods AMI patients(n=95) were retrospectively chosen from the First Affiliated Hospital of Xinjiang Medical University from Jan. 2015 to Dec. 2020, and they were followed up for 3 y. All patients were divided, according to MACE occurrence after PCI, into MACE group(n=42) and control group(n=53). The differences in clinical characteristics and parameters related to dual nuclide myocardial imaging were compared between 2 groups. The predictive value of parameters related to dual nuclide myocardial imaging to MACE was analyzed. Results The incidence of diabetes increased significantly(42.86% vs. 22.64%, P=0.035), severity of coronary stenosis increased significantly [(73.67±11.57)% vs.(66.11±8.69)%, P<0.001], left ventricular ejection fraction(LVEF) decreased significantly(47.45±3.83 vs. 52.13±4.31, P<0.001), the total score of myocardial ischemia increased significantly [(14.29±4.20)% vs.(9.89±3.33)%, P<0.001], and mismatch percentage of myocardial perfusion/metabolism increased significantly(16.58±1.61 vs. 15.69±2.14, P=0.028) in MACE group compared with control group. LVEF had some predictive value to MACE after PCI(AUC=0.777, 95%CI:0.686～0.868, P<0.001). The severity of coronary stenosis and the total score of myocardial ischemia had some predictive value to MACE after PCI(AUC=0.676, AUC=0.784). The results of multi-factor Logistics regression analysis showed that LVEF<50% and the total score of myocardial ischemia>12 were independent risk factors of MACE within 3 y after PCI in AMI patients(P<0.05). Conclusion The parameters related to dual nuclide myocardial imaging can be taken as one of predictive indicators for MACE in AMI patients after PCI.更多还原