【作者】 陈小明；

【导师】 李自成；

【作者基本信息】 暨南大学 ， 内科学， 2005， 硕士

【摘要】 目的:研究应用门控心肌灌注SPECT显像在冠心病患者预后评估方面的价值及对冠心病治疗方案选择方面的指导作用。 方法:对141例患者进行静息和运动负荷(²⁰¹Tl/^99mTc-MIBI/^99mTc-tetrofosmin)门控心肌灌注SPECT显像并随访46.38±23.70月。心肌灌注图像应用17节段的半定量评分法进行评分（1～4分）,计算总负荷评分（SSS）、总静息评分（SRS）和总差值分（SDS=SRS-SSS）,并自动定量计算负荷EF值和静息EF值。 结果:随访中14例发生心脏事件,发生率为2.57%/年。SSS、SDS、SRS以及EF值均是心脏事件的独立的预测因素（P<0.0005）。Cox比例风险回归分析显示SSS是心脏事件的最强的预测因素。根据患者的负荷后EF值、SDS值等可将患者分为低危、中危和高危组。 结论:应用门控心肌灌注SPECT显像可以对冠心病患者进行正确的预后评估,将患者分为低危、中危和高危组以选择恰当的治疗方案。SSS是心脏事件的最强预测因素。更多还原

【Abstract】 OBJECTIVE: To study the prognostic value of gated myocardial perfusion single photon emission computed tomography (SPECT) in patients with cardiac artery disease and its assistance in determining the appropriate treatment strategy for the individual patient.METHODS: We identified 141 consecutive patients who underwent rest and exercise stress (201Tl/99mTc-MIBI/ 99mTc-tetrofosmin) gated myocardial perfusion SPECT and who were followed-up for 46.38±23.70 months. Visual scoring of perfusion images used 17 segments and a scale of 1-4. and calculated the global summed stress score (SSS), summed rest score (SRS) and the summed difference score (SDS=SSS-SRS). Poststress ejection fraction (EF) and rest EF were automatically generated.RESULTS: 14 cardiac events occurred (2.57%/year). SSS, SDS,SRS and EF were the independent predictors of cardiac events (P<0.0005). Cox regression analysis showed that SSS was the best predictor of cardiac events. Integration of the poststress EF and SDS yielded effective stratification of patients into low-, intermediate-, and high-risk subgroups.CONCLUSIONS: Gated myocardial perfusion SPECT can provide appropriate prognostic assessment for the patients with cardiac artery disease and assistant in determining the appropriate treatment strategy for the individual patient by stratification of patients into low-, intermediate-, and high-risk subgroups. SSS was the best predictors of cardiac events.更多还原